Skip to main content

Pancreatic Cancer: Radiation Therapy Planning

  • Chapter
  • First Online:
Radiation Therapy for Gastrointestinal Cancers

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Barugola G, Falconi M, Bettini R, et al. The determinant factors of recurrence following resection for ductal pancreatic cancer. JOP. 2007;8(1 Suppl):132–40.

    PubMed  Google Scholar 

  2. Raut CP, Tseng JF, Sun CC, et al. Impact of resection status on pattern of failure and survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. Ann Surg. 2007;246(1):52–60.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Winter JM, Tang LH, Klimstra DS, et al. Failure patterns in resected pancreas adenocarcinoma: lack of predicted benefit to SMAD4 expression. Ann Surg. 2013;258(2):331–5.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Van den Broeck A, Sergeant G, Ectors N, Van Steenbergen W, Aerts R, Topal B. Patterns of recurrence after curative resection of pancreatic ductal adenocarcinoma. Eur J Surg Oncol. 2009;35(6):600–4.

    Article  CAS  PubMed  Google Scholar 

  5. Dholakia AS, Kumar R, Raman SP, et al. Mapping patterns of local recurrence after pancreaticoduodenectomy for pancreatic adenocarcinoma: a new approach to adjuvant radiation field design. Int J Radiat Oncol Biol Phys. 2013;87(5):1007–15.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hristov B, Reddy S, Lin SH, et al. Outcomes of adjuvant chemoradiation after pancreaticoduodenectomy with mesenterico-portal vein resection for adenocarcinoma of the pancreas. Int J Radiat Oncol Biol Phys. 2010;76(1):176–80.

    Article  CAS  PubMed  Google Scholar 

  7. Hallman JL, Mori S, Sharp GC, Lu HM, Hong TS, Chen GT. A four-dimensional computed tomography analysis of multiorgan abdominal motion. Int J Radiat Oncol Biol Phys. 2012;83(1):435–41.

    Article  PubMed  Google Scholar 

  8. Shiinoki T, Shibuya K, Nakamura M, et al. Interfractional reproducibility in pancreatic position based on four-dimensional computed tomography. Int J Radiat Oncol Biol Phys. 2011;80(5):1567–72.

    Article  PubMed  Google Scholar 

  9. Cattaneo GM, Passoni P, Sangalli G, et al. Internal target volume defined by contrast-enhanced 4D-CT scan in unresectable pancreatic tumour: evaluation and reproducibility. Radiother Oncol. 2010;97(3):525–9.

    Article  PubMed  Google Scholar 

  10. Goldstein SD, Ford EC, Duhon M, McNutt T, Wong J, Herman JM. Use of respiratory-correlated four-dimensional computed tomography to determine acceptable treatment margins for locally advanced pancreatic adenocarcinoma. Int J Radiat Oncol Biol Phys. 2010;76(2):597–602.

    Article  PubMed  Google Scholar 

  11. Gwynne S, Wills L, Joseph G, et al. Respiratory movement of upper abdominal organs and its effect on radiotherapy planning in pancreatic cancer. Clin Oncol (R Coll Radiol). 2009;21(9):713–9.

    Article  CAS  Google Scholar 

  12. Minn AY, Schellenberg D, Maxim P, et al. Pancreatic tumor motion on a single planning 4D-CT does not correlate with intrafraction tumor motion during treatment. Am J Clin Oncol. 2009;32(4):364–8.

    Article  PubMed  Google Scholar 

  13. Feng M, Balter JM, Normolle D, et al. Characterization of pancreatic tumor motion using cine MRI: surrogates for tumor position should be used with caution. Int J Radiat Oncol Biol Phys. 2009;74(3):884–91.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Henry AM, Ryder WD, Moore C, et al. Chemoradiotherapy for locally advanced pancreatic cancer: a radiotherapy dose escalation and organ motion study. Clin Oncol (R Coll Radiol). 2008;20(7):541–7.

    Article  CAS  Google Scholar 

  15. Bhasin DK, Rana SS, Jahagirdar S, Nagi B. Does the pancreas move with respiration? J Gastroenterol Hepatol. 2006;21(9):1424–7.

    PubMed  Google Scholar 

  16. Gierga DP, Chen GT, Kung JH, Betke M, Lombardi J, Willett CG. Quantification of respiration-induced abdominal tumor motion and its impact on IMRT dose distributions. Int J Radiat Oncol Biol Phys. 2004;58(5):1584–95.

    Article  PubMed  Google Scholar 

  17. Bussels B, Goethals L, Feron M, et al. Respiration-induced movement of the upper abdominal organs: a pitfall for the three-dimensional conformal radiation treatment of pancreatic cancer. Radiother Oncol. 2003;68(1):69–74.

    Article  PubMed  Google Scholar 

  18. Huguet F, Yorke ED, Davidson M, et al. Modeling pancreatic tumor motion using 4-dimensional computed tomography and surrogate markers. Int J Radiat Oncol Biol Phys. 2015;91(3):579–87.

    Article  PubMed  Google Scholar 

  19. Khashab MA, Kim KJ, Tryggestad EJ, et al. Comparative analysis of traditional and coiled fiducials implanted during EUS for pancreatic cancer patients receiving stereotactic body radiation therapy. Gastrointest Endosc. 2012;76(5):962–71.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Herman JM, Swartz MJ, Hsu CC, et al. Analysis of fluorouracil-based adjuvant chemotherapy and radiation after pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas: results of a large, prospectively collected database at the johns hopkins hospital. J Clin Oncol. 2008;26(21):3503–10.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Spalding AC, Jee KW, Vineberg K, et al. Potential for dose-escalation and reduction of risk in pancreatic cancer using IMRT optimization with lexicographic ordering and gEUD-based cost functions. Med Phys. 2007;34(2):521–9.

    Article  PubMed  Google Scholar 

  22. Yovino S, Poppe M, Jabbour S, et al. Intensity-modulated radiation therapy significantly improves acute gastrointestinal toxicity in pancreatic and ampullary cancers. Int J Radiat Oncol Biol Phys. 2011;79(1):158–62.

    Article  PubMed  Google Scholar 

  23. Rwigema JC, Heron DE, Parikh SD, et al. Adjuvant stereotactic body radiotherapy for resected pancreatic adenocarcinoma with close or positive margins. J Gastrointest Cancer. 2012;43(1):70–6.

    Article  PubMed  Google Scholar 

  24. Herman J, Parkinson R, Onners B, et al. Preliminary results of a pilot study evaluating an allogeneic GM-CSF pancreatic tumor cell vaccine (GVAX) and cytoxan (cy) with stereotactic body radiation therapy (SBRT) and folfirinox (FFX) in patients with resected pancreatic adenocarcinoma. Int J Radiat Oncol Biol Phys. 2015;93(3 Suppl):154.

    Article  Google Scholar 

  25. Chang DT, Schellenberg D, Shen J, et al. Stereotactic radiotherapy for unresectable adenocarcinoma of the pancreas. Cancer. 2009;115(3):665–72.

    Article  PubMed  Google Scholar 

  26. Moningi S, Marciscano AE, Rosati LM, et al. Stereotactic body radiation therapy in pancreatic cancer: The new frontier. Expert Rev Anticancer Ther. 2014;14(12):1461–75.

    Article  CAS  PubMed  Google Scholar 

  27. Herman JM, Chang DT, Goodman KA, et al. Phase 2 multi-institutional trial evaluating gemcitabine and stereotactic body radiotherapy for patients with locally advanced unresectable pancreatic adenocarcinoma. Cancer. 2015;121(7):1128–37.

    Article  CAS  PubMed  Google Scholar 

  28. Mahadevan A, Miksad R, Goldstein M, et al. Induction gemcitabine and stereotactic body radiotherapy for locally advanced nonmetastatic pancreas cancer. Int J Radiat Oncol Biol Phys. 2011;81(4):e615–22.

    Article  CAS  PubMed  Google Scholar 

  29. Chuong MD, Springett GM, Freilich JM, et al. Stereotactic body radiation therapy for locally advanced and borderline resectable pancreatic cancer is effective and well tolerated. Int J Radiat Oncol Biol Phys. 2013;86(3):516–22.

    Article  PubMed  Google Scholar 

  30. Lominska CE, Unger K, Nasr NM, Haddad N, Gagnon G. Stereotactic body radiation therapy for reirradiation of localized adenocarcinoma of the pancreas. Radiat Oncol. 2012;7:74. doi:10.1186/1748-717X-7-74.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Wild AT, Hiniker SM, Chang DT, et al. Re-irradiation with stereotactic body radiation therapy as a novel treatment option for isolated local recurrence of pancreatic cancer after multimodality therapy: experience from two institutions. J Gastrointest Oncol. 2013;4(4):343–51.

    PubMed  PubMed Central  Google Scholar 

  32. Dagoglu N, Callery M, Moser J, et al. Stereotactic body radiotherapy (SBRT) reirradiation for recurrent pancreas cancer. J Cancer. 2016;7(3):283–8.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Crane CH, Beddar AS, Evans DB. The role of intraoperative radiotherapy in pancreatic cancer. Surg Oncol Clin N Am. 2003;12(4):965–77.

    Article  PubMed  Google Scholar 

  34. Hong TS, Ryan DP, Borger DR, et al. A phase 1/2 and biomarker study of preoperative short course chemoradiation with proton beam therapy and capecitabine followed by early surgery for resectable pancreatic ductal adenocarcinoma. Int J Radiat Oncol Biol Phys. 2014;89(4):830–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Terashima K, Demizu Y, Hashimoto N, et al. A phase I/II study of gemcitabine-concurrent proton radiotherapy for locally advanced pancreatic cancer without distant metastasis. Radiother Oncol. 2012;103(1):25–31.

    Article  PubMed  Google Scholar 

  36. Nichols Jr RC, George TJ, Zaiden Jr RA, et al. Proton therapy with concomitant capecitabine for pancreatic and ampullary cancers is associated with a low incidence of gastrointestinal toxicity. Acta Oncol. 2013;52(3):498–505.

    Article  CAS  PubMed  Google Scholar 

  37. Kozak KR, Kachnic LA, Adams J, et al. Dosimetric feasibility of hypofractionated proton radiotherapy for neoadjuvant pancreatic cancer treatment. Int J Radiat Oncol Biol Phys. 2007;68(5):1557–66.

    Article  PubMed  Google Scholar 

  38. Lee RY, Nichols Jr RC, Huh SN, et al. Proton therapy may allow for comprehensive elective nodal coverage for patients receiving neoadjuvant radiotherapy for localized pancreatic head cancers. J Gastrointest Oncol. 2013;4(4):374–9.

    PubMed  PubMed Central  Google Scholar 

  39. Ding X, Dionisi F, Tang S, et al. A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT). Med Dosim. 2014;39(2):139–45.

    Article  PubMed  Google Scholar 

  40. Thompson RF, Mayekar SU, Zhai H, et al. A dosimetric comparison of proton and photon therapy in unresectable cancers of the head of pancreas. Med Phys. 2014;41(8):081711. doi: 10.1118/1.4887797.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joseph M. Herman MD, MSc .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Ram, A.N., Rosati, L.M., Herman, J.M. (2017). Pancreatic Cancer: Radiation Therapy Planning. In: Hong, T., Das, P. (eds) Radiation Therapy for Gastrointestinal Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-43115-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43115-4_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43113-0

  • Online ISBN: 978-3-319-43115-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics