Burkoň Petr, Trna Jan, Slávik Marek, Němeček Radim, Kazda Tomáš, Pospíšil Petr, Dastych Milan, Eid Michal, Novotný Ivo, Procházka Tomáš, Vrzal Miroslav
Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Zluty Kopec 7, 656 57 Brno, Czech Republic.
Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
Biomedicines. 2022 Oct 4;10(10):2480. doi: 10.3390/biomedicines10102480.
Pancreatic cancer is the third leading cause of cancer death in the developed world and is predicted to become the second by 2030. A cure may be achieved only with surgical resection of an early diagnosed disease. Surgery for more advanced disease is challenging and can be contraindicated for many reasons. Neoadjuvant therapy may improve the probability of achieving R0 resection. It consists of systemic treatment followed by radiation therapy applied concurrently or sequentially with cytostatics. A novel approach to irradiation, stereotactic body radiotherapy (SBRT), has the potential to improve treatment results. SBRT can deliver higher doses of radiation to the tumor in only a few treatment fractions. It has attracted significant interest for pancreatic cancer patients, as it is completed quickly, requires less time away from full-dose chemotherapy, and is well-tolerated than conventional radiotherapy. In this review, we aim to provide the reader with a basic overview of current evidence for SBRT indications in the treatment of pancreatic tumors. In the second part of the review, we focus on practical information with respect to SBRT treatment plan preparation the performance of such therapy. Finally, we discuss future directions related to the use of magnetic resonance linear accelerators.
胰腺癌是发达国家癌症死亡的第三大主要原因，预计到2030年将成为第二大原因。只有通过手术切除早期诊断的疾病才能实现治愈。针对更晚期疾病的手术具有挑战性，并且由于多种原因可能被禁忌。新辅助治疗可能会提高实现R0切除的概率。它包括全身治疗，然后是与细胞抑制剂同时或序贯应用的放射治疗。一种新的放射治疗方法，立体定向体部放射治疗（SBRT），有可能改善治疗效果。SBRT仅在少数几次治疗分割中就能向肿瘤输送更高剂量的辐射。它引起了胰腺癌患者的极大兴趣，因为它完成得很快，需要较少的时间中断全剂量化疗，并且比传统放疗耐受性更好。在本综述中，我们旨在为读者提供关于SBRT在胰腺肿瘤治疗中适应证的当前证据的基本概述。在综述的第二部分，我们关注与SBRT治疗计划准备以及这种治疗的实施相关的实用信息。最后，我们讨论与磁共振直线加速器使用相关的未来方向。
