Cellini Francesco, Arcelli Alessandra, Simoni Nicola, Caravatta Luciana, Buwenge Milly, Calabrese Angela, Brunetti Oronzo, Genovesi Domenico, Mazzarotto Renzo, Deodato Francesco, Mattiucci Gian Carlo, Silvestris Nicola, Valentini Vincenzo, Morganti Alessio Giuseppe
Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, 00168 Roma, Italy.
Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy.
Cancers (Basel). 2020 Jun 29;12(7):1729. doi: 10.3390/cancers12071729.
Pancreatic cancer represents a modern oncological urgency. Its management is aimed to both distal and local disease control. Resectability is the cornerstone of treatment aim. It influences the clinical presentation's definitions as up-front resectable, borderline resectable and locally advanced (unresectable). The main treatment categories are neoadjuvant (preoperative), definitive and adjuvant (postoperative). This review will focus on i) the current indications by the available national and international guidelines; ii) the current standard indications for target volume delineation in radiotherapy (RT); iii) the emerging modern technologies (including particle therapy and Magnetic Resonance [MR]-guided-RT); iv) stereotactic body radiotherapy (SBRT), as the most promising technical delivery application of RT in this framework; v) a particularly promising dose delivery technique called simultaneous integrated boost (SIB); and vi) a multimodal integration opportunity: the combination of RT with immunotherapy.
胰腺癌是现代肿瘤学的当务之急。其治疗旨在控制局部和远处疾病。可切除性是治疗目标的基石。它影响着临床表现的定义，如 upfront 可切除、边界可切除和局部晚期（不可切除）。主要治疗类别包括新辅助（术前）、根治性和辅助（术后）。本综述将聚焦于：i）现有国家和国际指南的当前适应证；ii）放射治疗（RT）中靶区勾画的当前标准适应证；iii）新兴的现代技术（包括粒子治疗和磁共振[MR]引导的 RT）；iv）立体定向体部放疗（SBRT），作为 RT 在该框架中最有前景的技术应用；v）一种特别有前景的剂量给予技术，称为同步整合推量（SIB）；以及 vi）一种多模式整合机会：RT 与免疫治疗的联合。
