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Title: Stereotactic radiotherapy and the potential role of magnetic resonance-guided adaptive techniques for pancreatic cancer.
Austin Authors: Ermongkonchai, Tai;Khor, Richard ;Muralidharan, Vijayaragavan ;Tebbutt, Niall C ;Lim, Kelvin K M ;Kutaiba, Numan ;Ng, Sweet Ping 
Affiliation: Radiology
Olivia Newton-John Cancer Wellness and Research Centre
Issue Date: 21-Feb-2022
Publication information: World journal of gastroenterology 2022; 28(7): 745-754
Abstract: Pancreatic cancer is a malignancy with one of the poorest prognoses amongst all cancers. Patients with unresectable tumours either receive palliative care or undergo various chemoradiotherapy regimens. Conventional techniques are often associated with acute gastrointestinal toxicities, as adjacent critical structures such as the duodenum ultimately limits delivered doses. Stereotactic body radiotherapy (SBRT) is an advanced radiation technique that delivers highly ablative radiation split into several fractions, with a steep dose fall-off outside target volumes. To discuss the latest data on SBRT and whether there is a role for magnetic resonance-guided techniques in multimodal management of locally advanced, unresectable pancreatic cancer. We conducted a search on multiple large databases to collate the latest records on radiotherapy techniques used to treat pancreatic cancer. Out of 1229 total records retrieved from our search, 36 studies were included in this review. Studies indicate that SBRT is associated with improved clinical efficacy and toxicity profiles compared to conventional radiotherapy techniques. Further dose escalation to the tumour with SBRT is limited by the poor soft-tissue visualisation of computed tomography imaging during radiation planning and treatment delivery. Magnetic resonance-guided techniques have been introduced to improve imaging quality, enabling treatment plan adaptation and re-optimisation before delivering each fraction. Therefore, SBRT may lead to improved survival outcomes and safer toxicity profiles compared to conventional techniques, and the addition of magnetic resonance-guided techniques potentially allows dose escalation and conversion of unresectable tumours to operable cases.
DOI: 10.3748/wjg.v28.i7.745
ORCID: 0000-0002-2210-5773
Journal: World journal of gastroenterology
PubMed URL: 35317275
PubMed URL:
Type: Journal Article
Subjects: Adaptive techniques
Magnetic resonance imaging
Pancreatic cancer
Appears in Collections:Journal articles

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