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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

Fit of the clinical data for treatment of LAUPC with X-ray radiotherapy alone. Studies are listed in Table 1. BED is calculated by Eq. 4. Fitting was performed by Eq. 2 and fitting parameters are in Table 3.
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Figure 2: Fit of the clinical data for treatment of LAUPC with X-ray radiotherapy alone. Studies are listed in Table 1. BED is calculated by Eq. 4. Fitting was performed by Eq. 2 and fitting parameters are in Table 3.

Mentions: The data are plotted in Figure 2, along with the fit using Eq. 2. Fitting parameters are reported in Table 2. The D50 = 107 Gy clearly shows how impractical is the treatment of LAUPC with X-rays alone. For comparison, Dale et al. (16) estimated a BED at 50% complete response for bladder cancer of 54.4 Gy. From the analysis of the trials using chemotherapy alone (10), an average 1-year survival below 20% can be estimated.


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

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

Fit of the clinical data for treatment of LAUPC with X-ray radiotherapy alone. Studies are listed in Table 1. BED is calculated by Eq. 4. Fitting was performed by Eq. 2 and fitting parameters are in Table 3.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 2: Fit of the clinical data for treatment of LAUPC with X-ray radiotherapy alone. Studies are listed in Table 1. BED is calculated by Eq. 4. Fitting was performed by Eq. 2 and fitting parameters are in Table 3.
Mentions: The data are plotted in Figure 2, along with the fit using Eq. 2. Fitting parameters are reported in Table 2. The D50 = 107 Gy clearly shows how impractical is the treatment of LAUPC with X-rays alone. For comparison, Dale et al. (16) estimated a BED at 50% complete response for bladder cancer of 54.4 Gy. From the analysis of the trials using chemotherapy alone (10), an average 1-year survival below 20% can be estimated.

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