摘要
Background and Objective:CybeKnife is a newly developed technology in the field of stereotactic radiosurgery/radiotherapy (SRS/SRT).Compared with conventional SRS/SRT, there are many advantages for CyberKnife in terms of treating tumors that move with respiration, being real-time image-guidance, frameless, high accurateness, and so on.Recently, it has been used to treat different types of malignant carcinoma including intracranial and caudomedial tumors.This study was designed to evaluate the short-term efficacy and toxicity of the CyberKnife radiotherapy for locally advanced pancreatic cancer.Methods:A total of 20 patients with locally advanced (stage II-III) pancreatic cancer treated with CyberKnife were recruited between April 2009 and December 2009.Of 20 patients, 13 were with cancer located at the pancreatic head and 7 were located at the pancreatic body and tail.The planning target volume (PTV) was defined as gross tumor volume (GTV) plus 2-3 mm, and more than 95% PTV should be covered by 75% isodose surface.The median of PTV was 47 cm3 (26-64 cm3).The median total prescription dose was 40 Gy (32-55 Gy) at 3-6 fractions.During treatment delivery, X-Sight Spine Tracking System was used in 5 patients to track movement of the tumor.Other 15 patients were implanted fiducials in the tumors to track movement of the tumor and patient breathing patterns.Results:The median follow-up time was 7 months (3-11 months).All patients had finished the treatment and 19 were alive by the last follow-up.Slight fatigue was the most common complain.Evaluated by CT scan, 6 were complete response, 9 were partial response, 3 were stable disease, and 1 was progression; 1 was dead.There were 6 patients with grade I granulocytopenia, 7 with grade I nausea, and 5 with grade II vomiting.Conclusions:The CyberKnife radiosurgery for the locally advanced pancreatic cancer shows a high rate of local control and minimal toxicity.Long-term follow-up is necessary to evaluate the survival and late toxicity.
Background and Objective：CybeKnife is a newly developed technology in the field of stereotactic radiosurgery/radiotherapy （SRS/SRT）.Compared with conventional SRS/SRT, there are many advantages for CyberKnife in terms of treating tumors that move with respiration, being real-time image-guidance, frameless, high accurateness, and so on.Recently, it has been used to treat different types of malignant carcinoma including intracranial and caudomedial tumors.This study was designed to evaluate the short-term efficacy and toxicity of the CyberKnife radiotherapy for locally advanced pancreatic cancer.Methods：A total of 20 patients with locally advanced （stage II-III） pancreatic cancer treated with CyberKnife were recruited between April 2009 and December 2009.Of 20 patients, 13 were with cancer located at the pancreatic head and 7 were located at the pancreatic body and tail.The planning target volume （PTV） was defined as gross tumor volume （GTV） plus 2-3 mm, and more than 95% PTV should be covered by 75% isodose surface.The median of PTV was 47 cm3 （26-64 cm3）.The median total prescription dose was 40 Gy （32-55 Gy） at 3-6 fractions.During treatment delivery, X-Sight Spine Tracking System was used in 5 patients to track movement of the tumor.Other 15 patients were implanted fiducials in the tumors to track movement of the tumor and patient breathing patterns.Results：The median follow-up time was 7 months （3-11 months）.All patients had finished the treatment and 19 were alive by the last follow-up.Slight fatigue was the most common complain.Evaluated by CT scan, 6 were complete response, 9 were partial response, 3 were stable disease, and 1 was progression; 1 was dead.There were 6 patients with grade I granulocytopenia, 7 with grade I nausea, and 5 with grade II vomiting.Conclusions：The CyberKnife radiosurgery for the locally advanced pancreatic cancer shows a high rate of local control and minimal toxicity.Long-term follow-up is necessary to evaluate the survival and late toxicity.
基金
Youth Foundation of Nanjing General Hospital of Nanjing Military Command (No.2009Q051)
