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Annals of Pancreatic Cancer最新文献

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Technical aspects of modern radiation therapy for pancreatic adenocarcinoma: field design, motion management, dosing, and concurrent therapy 现代胰腺腺癌放射治疗的技术方面:放射场设计、运动管理、剂量和同步治疗
Annals of Pancreatic Cancer Pub Date : 2018-08-01 DOI: 10.21037/APC.2018.07.06
A. Narang
{"title":"Technical aspects of modern radiation therapy for pancreatic adenocarcinoma: field design, motion management, dosing, and concurrent therapy","authors":"A. Narang","doi":"10.21037/APC.2018.07.06","DOIUrl":"https://doi.org/10.21037/APC.2018.07.06","url":null,"abstract":"The role of radiation for pancreatic cancer has historically been controversial with multiple randomized trials reporting conflicting results in both the adjuvant and locally advanced setting. However, most of the phase III trials for pancreatic cancer employed antiquated radiation techniques, rendering their applicability to the question of the role of modern day radiation unclear. Indeed, recent advances in treatment planning, motion management, and image guidance have provided radiation oncologists with a new armamentarium to solve the challenge of delivering sufficiently high dose to a highly mobile target that is surrounded by exquisitely radiosensitive structures, with recent data providing significant reason for optimism about the role of radiation across all stages of pancreatic cancer. Herein, we review the technical aspects of the delivery of modern radiation delivery for pancreatic cancer, both as neoadjuvant and definitive therapy for intact pancreatic tumors as well as adjuvant therapy for resected pancreatic tumors. We discuss each step of the radiation process, from simulation to contouring to treatment planning to treatment delivery, with a focus on recent data addressing critical questions as well as the strategies that have been employed to address these questions. A detailed understanding of these technical considerations is critical for any radiation oncologist treating pancreatic cancer, but also for medical and surgical oncology colleagues integrating multi-disciplinary care. Fluency in this information will yield an appreciation of the potential for radiation for patients with pancreatic cancer as well as the remaining challenges ahead.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83801097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Altering the response to radiation: radiosensitizers and targeted therapies in pancreatic ductal adenocarcinoma: preclinical and emerging clinical evidence. 改变对放射的反应:胰腺导管腺癌的放射增敏剂和靶向治疗:临床前和新出现的临床证据。
Annals of Pancreatic Cancer Pub Date : 2018-08-01 Epub Date: 2018-08-31 DOI: 10.21037/apc.2018.08.02
Adam R Wolfe, Terence M Williams
{"title":"Altering the response to radiation: radiosensitizers and targeted therapies in pancreatic ductal adenocarcinoma: preclinical and emerging clinical evidence.","authors":"Adam R Wolfe,&nbsp;Terence M Williams","doi":"10.21037/apc.2018.08.02","DOIUrl":"https://doi.org/10.21037/apc.2018.08.02","url":null,"abstract":"<p><p>Radiation therapy continues to have an evolving role in pancreatic ductal adenocarcinoma. While metastatic failure likely contributes to the majority of patient mortality, achieving local control through surgery and/or radiation appears to be important as certain studies suggest that mortality is contributed by local failure. Many studies support that pancreatic cancer is a relatively radiation resistant tumor type. In addition, the ability to further improve radiation through dose escalation strategies in the non-metastatic setting is hampered by closeness of normal organs, including small bowel and stomach, to the tumor. Thus subverting molecular pathways that promote radiation resistance will be critical to further success of radiation in this disease. There is a wealth of preclinical data supporting the targeting of various molecular pathways in combination with radiation therapy, including DNA repair, cell cycle checkpoint proteins, receptor tyrosine kinases, oncoproteins, stem cells, and immunomodulation. A number of clinical trials have been completed or are on-going with novel molecular inhibitors. In this review, we summarize existing preclinical and clinical molecular strategies for improving the efficacy of radiation in pancreatic cancer, and highlight recent and ongoing clinical trials combining radiation and various targeted therapies.</p>","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"1 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/apc.2018.08.02","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38152188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Revisiting radiotherapy for pancreatic cancer 胰腺癌放射治疗的重访
Annals of Pancreatic Cancer Pub Date : 2018-08-01 DOI: 10.21037/apc.2018.08.01
R. Tuli
{"title":"Revisiting radiotherapy for pancreatic cancer","authors":"R. Tuli","doi":"10.21037/apc.2018.08.01","DOIUrl":"https://doi.org/10.21037/apc.2018.08.01","url":null,"abstract":"Pancreatic cancer is the eighth most common cancer diagnosed in the United States (US) yet the third deadliest. This devastating disease is estimated to become the second leading cause of cancer deaths by 2030 largely due to the high rate of occult metastatic disease and significant tumor heterogeneity, rendering unselected therapies ineffective.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88658461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dr. Barish H. Edil: changes and future development on pancreatic cancer treatment Barish H. Edil博士:胰腺癌治疗的变化和未来发展
Annals of Pancreatic Cancer Pub Date : 2018-08-01 DOI: 10.21037/apc.2018.08.03
V. Wong, Luna Young
{"title":"Dr. Barish H. Edil: changes and future development on pancreatic cancer treatment","authors":"V. Wong, Luna Young","doi":"10.21037/apc.2018.08.03","DOIUrl":"https://doi.org/10.21037/apc.2018.08.03","url":null,"abstract":"The 4th International HBP Surgery Forum was held in Hangzhou, Zhejiang Province on 14–17 June, 2018. The Forum is organized by The Second Affiliated Hospital Zhejiang University School of Medicine (ZUSAH) and the Zhejiang Anti-Cancer Association. The International HBP Surgery Forum, held every two years, has now become a magnificent gathering for the researchers, whom are related to HBP surgery to share with us their recent research work.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90877945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current and emerging radiotherapy strategies for pancreatic adenocarcinoma: stereotactic, intensity modulated and particle radiotherapy. 当前和新兴的胰腺腺癌放疗策略:立体定向、强度调节和粒子放疗。
Annals of Pancreatic Cancer Pub Date : 2018-08-01 Epub Date: 2018-08-13 DOI: 10.21037/apc.2018.07.03
Sweet Ping Ng, Eugene J Koay
{"title":"Current and emerging radiotherapy strategies for pancreatic adenocarcinoma: stereotactic, intensity modulated and particle radiotherapy.","authors":"Sweet Ping Ng,&nbsp;Eugene J Koay","doi":"10.21037/apc.2018.07.03","DOIUrl":"https://doi.org/10.21037/apc.2018.07.03","url":null,"abstract":"<p><p>The role of radiotherapy for locally advanced pancreatic cancer (LAPC) is unclear based on studies that used conventional doses and fractionation schedules. Modern radiotherapy techniques have not been studied in depth, however. We reviewed the literature on emerging methods of delivering higher doses of conformal radiotherapy using stereotactic body radiation, intensity modulated radiation, and particle beam radiation, highlighting clinical outcomes and toxicities. The literature review suggests low rates of acute and late toxicities when higher doses of radiation are given with careful attention to normal tissue dose constraints, including for stereotactic body radiotherapy (SBRT), escalated doses with intensity modulated radiation therapy (IMRT), and particle-based therapy. Retrospective evidence suggests prolonged survival for patients who receive biological equivalent doses above 70 Gy. Prospective trials that evaluate modern radiotherapy techniques are warranted for LAPC.</p>","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"1 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/apc.2018.07.03","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36477171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
Radiation induced antitumor autoimmunity: immunotherapies and pancreatic adenocarcinoma 放射诱导的抗肿瘤自身免疫:免疫疗法与胰腺腺癌
Annals of Pancreatic Cancer Pub Date : 2018-08-01 DOI: 10.21037/apc.2018.07.04
Dae Won Kim, Ethan Y. Song, S. Hoffe
{"title":"Radiation induced antitumor autoimmunity: immunotherapies and pancreatic adenocarcinoma","authors":"Dae Won Kim, Ethan Y. Song, S. Hoffe","doi":"10.21037/apc.2018.07.04","DOIUrl":"https://doi.org/10.21037/apc.2018.07.04","url":null,"abstract":"Radiation therapy plays a critical role for the local control of cancer by direct cytotoxicity. In addition to the direct target effect, radiation therapy can modify the immunosuppressive tumor microenvironment. Preclinical data have demonstrated that radiation can enhance the anticancer activity of cancer immunotherapy. In addition, several clinical studies have revealed that local radiation treatment could induce systemic tumor responses by radiation induced antitumor immunity. Here, we review preclinical and clinical evidence of the immunomodulatory effects of radiation and the preclinical rationale of combination of radiation and immunotherapy as a potential treatment strategy in pancreatic cancer.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"151 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72576111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neoadjuvant therapy in upfront resectable pancreatic cancer: current evidence and future considerations 早期可切除胰腺癌的新辅助治疗:当前证据和未来考虑
Annals of Pancreatic Cancer Pub Date : 2018-07-01 DOI: 10.21037/APC.2018.07.01
J. Gong, Jeremy Chuang, A. Hendifar, R. Tuli
{"title":"Neoadjuvant therapy in upfront resectable pancreatic cancer: current evidence and future considerations","authors":"J. Gong, Jeremy Chuang, A. Hendifar, R. Tuli","doi":"10.21037/APC.2018.07.01","DOIUrl":"https://doi.org/10.21037/APC.2018.07.01","url":null,"abstract":"Neoadjuvant therapy represents an increasingly recognized strategy in the management of radiographically resectable pancreatic cancer. The rationale behind neoadjuvant therapy includes the potential to increase the likelihood in achieving margin-negative resections, completing multimodality therapy, improving cost-effectiveness, and identifying poor candidates for surgery. In this review, we highlight current data from prospective clinical trials describing the feasibility and efficacy of neoadjuvant therapy in resectable pancreatic cancer. We end with a discussion on future considerations and unanswered questions important in establishing neoadjuvant therapy as part of the standard treatment paradigm for upfront resectable pancreatic cancer.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75696884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dr. Jun Yu: biomarkers in pancreatic cancer: recent advances and foreseeable future development 于君博士:胰腺癌的生物标志物:最近的进展和可预见的未来发展
Annals of Pancreatic Cancer Pub Date : 2018-07-01 DOI: 10.21037/APC.2018.07.02
Crystal M. Yan
{"title":"Dr. Jun Yu: biomarkers in pancreatic cancer: recent advances and foreseeable future development","authors":"Crystal M. Yan","doi":"10.21037/APC.2018.07.02","DOIUrl":"https://doi.org/10.21037/APC.2018.07.02","url":null,"abstract":"Jun Yu ( Figure 1 ), MD, PhD is an Assistant Professor in the Department of Surgery, Division of Hepatobiliary and Pancreas Surgery at the Johns Hopkins University School of Medicine. He is the Chief Scientist of Division of Hepatobiliary and Pancreas Surgery at Johns Hopkins. Dr. Yu received his medical degree from Gannan Medical University in China and a PhD in Surgery and Oncology from Kyushu University School of Medicine in Japan.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73865869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can computational modeling help in personalizing the care of patients with pancreatic ductal adenocarcinoma? 计算模型能否帮助胰腺导管腺癌患者的个性化护理?
Annals of Pancreatic Cancer Pub Date : 2018-05-01 Epub Date: 2018-05-24 DOI: 10.21037/apc.2018.05.01
Efrat Dotan
{"title":"Can computational modeling help in personalizing the care of patients with pancreatic ductal adenocarcinoma?","authors":"Efrat Dotan","doi":"10.21037/apc.2018.05.01","DOIUrl":"https://doi.org/10.21037/apc.2018.05.01","url":null,"abstract":"","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"1 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/apc.2018.05.01","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38099207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Prof. Min Li: three heads are better than one 李敏教授:三个臭皮匠胜过一个诸葛亮
Annals of Pancreatic Cancer Pub Date : 2018-03-09 DOI: 10.21037/apc.2018.08.04
Hailing Lian, Molly J. Wang
{"title":"Prof. Min Li: three heads are better than one","authors":"Hailing Lian, Molly J. Wang","doi":"10.21037/apc.2018.08.04","DOIUrl":"https://doi.org/10.21037/apc.2018.08.04","url":null,"abstract":"On June 17, 2018, the 4 th International HBP Surgery Forum successfully ended, after a 4-day scientific agenda. The event took place in Hangzhou, a beautiful city located in China. With the presence of so many prestigious local and foreign experts, it has been an excellent conference, which is helpful to the therapy of hepatobiliary and pancreatic tumors, hepatic and gall diseases and pancreatic diseases and also enhances the exchange of ERAS, MDT and the relevant researches.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82031356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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