PDF(Pubmed)
Abstract：
UNASSIGNED: This systematic review aims to comprehensively summarize the current prospective evidence regarding Stereotactic Body Radiotherapy (SBRT) in various clinical contexts for pancreatic cancer including its use as neoadjuvant therapy for borderline resectable pancreatic cancer (BRPC), induction therapy for locally advanced pancreatic cancer (LAPC), salvage therapy for isolated local recurrence (ILR), adjuvant therapy after radical resection, and as a palliative treatment. Special attention is given to the application of magnetic resonance-guided radiotherapy (MRgRT).
UNASSIGNED: Following PRISMA guidelines, a systematic review of the Medline database via PubMed was conducted focusing on prospective studies published within the past decade. Data were extracted concerning study characteristics, outcome measures, toxicity profiles, SBRT dosage and fractionation regimens, as well as additional systemic therapies.
UNASSIGNED: 31 studies with in total 1,571 patients were included in this review encompassing 14 studies for LAPC, 9 for neoadjuvant treatment, 2 for adjuvant treatment, 2 for ILR, with an additional 4 studies evaluating MRgRT. In LAPC, SBRT demonstrates encouraging results, characterized by favorable local control rates. Several studies even report conversion to resectable disease with substantial resection rates reaching 39%. The adoption of MRgRT may provide a solution to the challenge to deliver ablative doses while minimizing severe toxicities. In BRPC, select prospective studies combining preoperative ablative-dose SBRT with modern induction systemic therapies have achieved remarkable resection rates of up to 80%. MRgRT also holds potential in this context. Adjuvant SBRT does not appear to confer relevant advantages over chemotherapy. While prospective data for SBRT in ILR and for palliative pain relief are limited, they corroborate positive findings from retrospective studies.
UNASSIGNED: Following PRISMA guidelines, a systematic review of the Medline database via PubMed was conducted focusing on prospective studies published within the past decade. Data were extracted concerning study characteristics, outcome measures, toxicity profiles, SBRT dosage and fractionation regimens, as well as additional systemic therapies.
UNASSIGNED: 31 studies with in total 1,571 patients were included in this review encompassing 14 studies for LAPC, 9 for neoadjuvant treatment, 2 for adjuvant treatment, 2 for ILR, with an additional 4 studies evaluating MRgRT. In LAPC, SBRT demonstrates encouraging results, characterized by favorable local control rates. Several studies even report conversion to resectable disease with substantial resection rates reaching 39%. The adoption of MRgRT may provide a solution to the challenge to deliver ablative doses while minimizing severe toxicities. In BRPC, select prospective studies combining preoperative ablative-dose SBRT with modern induction systemic therapies have achieved remarkable resection rates of up to 80%. MRgRT also holds potential in this context. Adjuvant SBRT does not appear to confer relevant advantages over chemotherapy. While prospective data for SBRT in ILR and for palliative pain relief are limited, they corroborate positive findings from retrospective studies.
摘要：
■本系统综述旨在全面总结当前关于立体定向放射治疗（SBRT）在各种胰腺癌临床环境中的前瞻性证据，包括将其用作临界可切除胰腺癌（BRPC）的新辅助治疗。局部晚期胰腺癌（LAPC）的诱导治疗，孤立性局部复发（ILR）的挽救治疗，根治性切除术后的辅助治疗，作为一种姑息治疗。特别注意磁共振引导放射治疗（MRgRT）的应用。
■遵循PRISMA准则，我们通过PubMed对Medline数据库进行了系统评价,重点关注过去10年发表的前瞻性研究.提取有关研究特征的数据，结果衡量标准，毒性概况，SBRT剂量和分级方案，以及其他系统疗法。
■本综述共纳入了1,571例患者的31项研究，包括14项LAPC研究，9用于新辅助治疗，2用于辅助治疗，2用于ILR，另有4项研究评估MRgRT。在LAPC,SBRT展示了令人鼓舞的结果，以有利的局部控制率为特征。一些研究甚至报告转化为可切除的疾病，切除率达到39％。MRgRT的采用可以为挑战提供解决方案,以递送消融剂量,同时最小化严重毒性。在BRPC中,选择的前瞻性研究将术前消融剂量SBRT与现代诱导全身治疗相结合,已取得了高达80%的显著切除率.MRgRT在这种情况下也具有潜力。辅助SBRT似乎没有赋予化疗的相关优势。虽然SBRT在ILR和姑息性疼痛缓解方面的前瞻性数据有限，他们证实了回顾性研究的积极结果。
■遵循PRISMA准则，我们通过PubMed对Medline数据库进行了系统评价,重点关注过去10年发表的前瞻性研究.提取有关研究特征的数据，结果衡量标准，毒性概况，SBRT剂量和分级方案，以及其他系统疗法。
■本综述共纳入了1,571例患者的31项研究，包括14项LAPC研究，9用于新辅助治疗，2用于辅助治疗，2用于ILR，另有4项研究评估MRgRT。在LAPC,SBRT展示了令人鼓舞的结果，以有利的局部控制率为特征。一些研究甚至报告转化为可切除的疾病，切除率达到39％。MRgRT的采用可以为挑战提供解决方案,以递送消融剂量,同时最小化严重毒性。在BRPC中,选择的前瞻性研究将术前消融剂量SBRT与现代诱导全身治疗相结合,已取得了高达80%的显著切除率.MRgRT在这种情况下也具有潜力。辅助SBRT似乎没有赋予化疗的相关优势。虽然SBRT在ILR和姑息性疼痛缓解方面的前瞻性数据有限，他们证实了回顾性研究的积极结果。
