Panje Cédric, Andratschke Nikolaus, Brunner Thomas B, Niyazi Maximilian, Guckenberger Matthias
Department of Radiation Oncology, Zurich University Hospital, Rämistrasse 100, 8091, Zurich, Switzerland.
Department of Radiation Oncology, Freiburg University Hospital, Freiburg, Germany.
Strahlenther Onkol. 2016 Dec;192(12):875-885. doi: 10.1007/s00066-016-1053-1. Epub 2016 Oct 24.
This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a literature review and practice recommendations for stereotactic body radiotherapy (SBRT) of primary renal cell cancer and primary pancreatic cancer.
A literature search on SBRT for both renal cancer and pancreatic cancer was performed with focus on prospective trials and technical aspects for clinical implementation.
Data on renal and pancreatic SBRT are limited, but show promising rates of local control for both treatment sites. For pancreatic cancer, fractionated SBRT should be preferred to single-dose treatment to reduce the risk of gastrointestinal toxicity. Motion-compensation strategies and image guidance are paramount for safe SBRT delivery in both tumor entities.
SBRT for renal cancer and pancreatic cancer have been successfully evaluated in phase I and phase II trials. Pancreatic SBRT should be practiced carefully and only within prospective protocols due to the risk of severe gastrointestinal toxicity. SBRT for primary renal cell cancer appears a viable option for medically inoperable patients but future research needs to better define patient selection criteria and the detailed practice of SBRT.
德国放射肿瘤学会（DEGRO）立体定向放射治疗工作组的本报告旨在对原发性肾细胞癌和原发性胰腺癌的立体定向体部放射治疗（SBRT）进行文献综述并提供实践建议。
针对肾癌和胰腺癌的SBRT进行了文献检索，重点关注前瞻性试验和临床实施的技术方面。
关于肾和胰腺SBRT的数据有限，但两个治疗部位的局部控制率都很有前景。对于胰腺癌，分次SBRT应优先于单次剂量治疗，以降低胃肠道毒性风险。运动补偿策略和图像引导对于两个肿瘤实体的安全SBRT实施至关重要。
肾癌和胰腺癌的SBRT已在I期和II期试验中成功评估。由于存在严重胃肠道毒性风险，胰腺SBRT应谨慎实施，且仅在前瞻性方案内进行。对于医学上无法手术的患者，原发性肾细胞癌的SBRT似乎是一种可行的选择，但未来的研究需要更好地确定患者选择标准和SBRT的详细实践。
