Hypofractionated radiotherapy in pancreatic cancer : Lessons from the past in the era of stereotactic body radiation therapy
Cette étude passe en revue les études concernant l'intérêt, du point de vue du contrôle de la maladie, de la survie ou de la toxicité, d'une radiothérapie hypofractionnée standard et d'une radiothérapie corporelle stéréotaxique dans le traitement d'un cancer du pancréas
The role of neoadjuvant and definitive radiotherapy combined or not to chemotherapy in the therapeutic approach to pancreatic cancer has not been yet elucidated. There is some evidence in favour of neoadjuvant local and/or systemic approaches that enable surgical resection in patients initially considered to be “borderline resectable”. Nevertheless, most of these studies have been conducted using schedules of radiotherapy (treatment volumes, total doses, dose/fraction) that are nowadays considered not efficient enough and/or too toxic. Recently, stereotactic body radiation therapy (SBRT) has been proposed as a new therapeutic option for pancreatic cancer, both in the neoadjuvant and in the definitive setting. The aim of this study is to review the radiobiological and clinical evidences supporting hypofractionation in pancreatic cancer. Moreover, we performed an extensive review of available clinical and dosimetric data on SBRT in pancreatic cancer.
http://www.sciencedirect.com/science/article/pii/S1040842816301093