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Modeling Combined Chemotherapy and Particle Therapy for Locally Advanced Pancreatic Cancer.

Durante M, Tommasino F, Yamada S - Front Oncol (2015)

Bottom Line: Pancreatic ductal adenocarcinoma is the only cancer for which deaths are predicted to increase in 2014 and beyond.We compared published data on X-ray and charged particle clinical results with or without adjuvant chemotherapy calculating the biological effective dose.We show that chemoradiotherapy with protons or carbon ions results in 1 year OS significantly higher than those obtained with other treatment schedules.

View Article: PubMed Central - PubMed

Affiliation: Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung , Darmstadt , Germany ; Department of Physics, Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), University of Trento , Trento , Italy.

ABSTRACT
Pancreatic ductal adenocarcinoma is the only cancer for which deaths are predicted to increase in 2014 and beyond. Combined radiochemotherapy protocols using gemcitabine and hypofractionated X-rays are ongoing in several clinical trials. Recent results indicate that charged particle therapy substantially increases local control of resectable and unresectable pancreas cancer, as predicted from previous radiobiology studies considering the high tumor hypoxia. Combination with chemotherapy improves the overall survival (OS). We compared published data on X-ray and charged particle clinical results with or without adjuvant chemotherapy calculating the biological effective dose. We show that chemoradiotherapy with protons or carbon ions results in 1 year OS significantly higher than those obtained with other treatment schedules. Further hypofractionation using charged particles may result in improved local control and survival. A comparative clinical trial using the standard X-ray scheme vs. the best current standard with carbon ions is crucial and may open new opportunities for this deadly disease.

No MeSH data available.


Related in: MedlinePlus

Diagram summarizing the selection criteria of the studies included in the analysis.
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Figure 1: Diagram summarizing the selection criteria of the studies included in the analysis.

Mentions: We searched the literature for all data available on radiotherapy, chemotherapy, and combined treatments. The research criteria and outcomes are summarized in the diagram shown in Figure 1. The patient populations generally consist of adults with adenocarcinoma histology, locally advanced tumor presentation, and generally tumors not in direct contact to duodenum and stomach. Radiotherapy included conformal radiotherapy (3DCRT), intensity-modulated radiation therapy (IMRT), stereotactic body radiotherapy (SBRT), protontherapy, and CIRT. Data from CIRT are limited to the NIRS experience and include data as yet only published in the institute annual report and in a recent book (9). Adjuvant, neo-adjuvant, or concomitant chemotherapies were all included in the search, using different drugs. Our data collection was compared with a recent meta-analysis of radiochemotherapy in LAUPC (10), and has been updated on April 2015.


Modeling Combined Chemotherapy and Particle Therapy for Locally Advanced Pancreatic Cancer.

Durante M, Tommasino F, Yamada S - Front Oncol (2015)

Diagram summarizing the selection criteria of the studies included in the analysis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492201&req=5

Figure 1: Diagram summarizing the selection criteria of the studies included in the analysis.
Mentions: We searched the literature for all data available on radiotherapy, chemotherapy, and combined treatments. The research criteria and outcomes are summarized in the diagram shown in Figure 1. The patient populations generally consist of adults with adenocarcinoma histology, locally advanced tumor presentation, and generally tumors not in direct contact to duodenum and stomach. Radiotherapy included conformal radiotherapy (3DCRT), intensity-modulated radiation therapy (IMRT), stereotactic body radiotherapy (SBRT), protontherapy, and CIRT. Data from CIRT are limited to the NIRS experience and include data as yet only published in the institute annual report and in a recent book (9). Adjuvant, neo-adjuvant, or concomitant chemotherapies were all included in the search, using different drugs. Our data collection was compared with a recent meta-analysis of radiochemotherapy in LAUPC (10), and has been updated on April 2015.

Bottom Line: Pancreatic ductal adenocarcinoma is the only cancer for which deaths are predicted to increase in 2014 and beyond.We compared published data on X-ray and charged particle clinical results with or without adjuvant chemotherapy calculating the biological effective dose.We show that chemoradiotherapy with protons or carbon ions results in 1 year OS significantly higher than those obtained with other treatment schedules.

View Article: PubMed Central - PubMed

Affiliation: Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung , Darmstadt , Germany ; Department of Physics, Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), University of Trento , Trento , Italy.

ABSTRACT
Pancreatic ductal adenocarcinoma is the only cancer for which deaths are predicted to increase in 2014 and beyond. Combined radiochemotherapy protocols using gemcitabine and hypofractionated X-rays are ongoing in several clinical trials. Recent results indicate that charged particle therapy substantially increases local control of resectable and unresectable pancreas cancer, as predicted from previous radiobiology studies considering the high tumor hypoxia. Combination with chemotherapy improves the overall survival (OS). We compared published data on X-ray and charged particle clinical results with or without adjuvant chemotherapy calculating the biological effective dose. We show that chemoradiotherapy with protons or carbon ions results in 1 year OS significantly higher than those obtained with other treatment schedules. Further hypofractionation using charged particles may result in improved local control and survival. A comparative clinical trial using the standard X-ray scheme vs. the best current standard with carbon ions is crucial and may open new opportunities for this deadly disease.

No MeSH data available.


Related in: MedlinePlus