Real-Time MRI-guided Radiation Therapy for Locally Advanced Pancreatic Tail Cancer in Contact with The Colon

Yukihiro Hama, Etsuko Tate

Abstract


Introduction: Curative radiation therapy for locally advanced pancreatic ductal adenocarcinoma (PDAC) is difficult when the tumor is in contact with the colon. In this regard, MRI-guided radiation therapy (MRgRT) provides real-time MRI during radiation therapy, resulting in highdose radiation delivery to the target while avoiding surrounding organs at risk (OARs), such as the intestinal tract.

Case Presentation: A 94-year-old woman with locally advanced PDAC in the pancreatic tail underwent high-dose (72 Gy/30 fractions) real-time hypo-fractionated MRgRT to avoid irradiation of the colon. Three months after MRgRT, her serum CA 19-9 level normalized, and the tumor regressed completely. No adverse event or recurrence was noted during the six-month follow-up period.

Conclusions: High-dose hypo-fractionated MRgRT may be a treatment option for a patient with locally advanced PDAC of the pancreatic tail, which is in contact with the colon.


Keywords


Image-guided radiotherapy, pancreatic cancer, palliative

Full Text: View | Download

DOI: 10.33371/ijoc.v17i1.947

Article Metrics

Abstract View: 181,
PDF Download: 161
             

References


Principe DR, Underwood PW, Korc M, et al. The

Current Treatment Paradigm for Pancreatic Ductal

Adenocarcinoma and Barriers to Therapeutic Efficacy.

Front Oncol. 2021 Jul 15;11:688377.

Park W, Chawla A, O’Reilly EM. Pancreatic Cancer:

A Review. JAMA. 2021 Sep 7;326(9):851–862.

Hall WA, Small C, Paulson E, et al. Magnetic

resonance guided radiation therapy for pancreatic

adenocarcinoma, advantages, challenges, current

approaches, and future directions. Front Oncol.

;11:628155.

Park HJ, Griffin RJ, Hui S, et al. Radiation-induced

vascular damage in tumors: Implications of vascular

damage in ablative hypofractionated radiotherapy

(SBRT and SRS). Radiat Res 2012;177(3):311–327.

Reyngold M, Parikh P, Crane CH. Ablative radiation

therapy for locally advanced pancreatic cancer:

techniques and results. Radiat Oncol 2019;14:95

Garau MMI. Radiobiology of stereotactic body

radiation therapy (SBRT). Rep Pract Oncol Radiother.

Mar-Apr;22(2):86–95.

Vital Statistics of Japan. 2022. Available from:

https://www.mhlw.go.jp/toukei/saikin/hw/life/

life20/dl/life18-09.pdf


Refbacks

  • There are currently no refbacks.


Copyright (c) 2023 Indonesian Journal of Cancer

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.