Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California.
Department of Radiation Oncology, Northwell Health Cancer Institute, New Hyde Park, New York.
Pract Radiat Oncol. 2024 Nov-Dec;14(6):555-573. doi: 10.1016/j.prro.2024.06.004. Epub 2024 Jul 8.
The use of radiation therapy (RT) for pancreatic cancer continues to be controversial, despite recent technical advances. Improvements in systemic control have created an evolving role for RT and the need for improved local tumor control, but currently, no standardized approach exists. Advances in stereotactic body RT, motion management, real-time image guidance, and adaptive therapy have renewed hopes of improved outcomes in this devastating disease with one of the lowest survival rates. This case-based guide provides a practical framework for delivering stereotactic body RT for locally advanced pancreatic cancer. In conjunction with multidisciplinary care, an intradisciplinary approach should guide treatment of the high-risk cases outlined within these guidelines for prospective peer review and treatment safety discussions.
尽管近年来技术取得了进步,但放射治疗(RT)在胰腺癌中的应用仍存在争议。系统控制的改善为 RT 创造了一个不断发展的角色,并且需要提高局部肿瘤控制,但目前尚不存在标准化的方法。立体定向体部 RT、运动管理、实时图像引导和自适应治疗的进步为改善这种生存率最低的毁灭性疾病的结果带来了新的希望。本基于病例的指南为局部晚期胰腺癌提供了立体定向体部 RT 的实用框架。与多学科护理相结合,应该采用学科内方法来指导这些指南中概述的高危病例的治疗,以进行前瞻性同行评审和治疗安全讨论。