Radiation Therapy for Pancreatic Cancer: Executive Summary of an ASTRO Clinical Practice Guideline.

Autor:	Palta M; Department of Radiation Oncology, Duke University, Durham, North Carolina. Electronic address: manisha.palta@duke.edu., Godfrey D; Department of Radiation Oncology, Duke University, Durham, North Carolina., Goodman KA; Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado., Hoffe S; Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida., Dawson LA; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology University of Toronto, Toronto, Ontario, Canada., Dessert D; Patient representative, Wylie, Texas., Hall WA; Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin., Herman JM; Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas., Khorana AA; Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio., Merchant N; Division of Surgical Oncology University of Miami, Miami, Florida., Parekh A; Department of Radiation Oncology, Banner MD Anderson Cancer Center, Phoenix, Arizona., Patton C; American Society for Radiation Oncology, Arlington, Virginia., Pepek JM; Princeton Radiation Oncology, Princeton, New Jersey., Salama JK; Department of Radiation Oncology, Duke University, Durham, North Carolina; Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina., Tuli R; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York., Koong AC; Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas.
Jazyk:	angličtina
Zdroj:	Practical radiation oncology [Pract Radiat Oncol] 2019 Sep - Oct; Vol. 9 (5), pp. 322-332.
DOI:	10.1016/j.prro.2019.06.016
Abstrakt:	Purpose: This guideline systematically reviews the evidence for treatment of pancreatic cancer with radiation in the adjuvant, neoadjuvant, definitive, and palliative settings and provides recommendations on indications and technical considerations. Methods and Materials: The American Society for Radiation Oncology convened a task force to address 7 key questions focused on radiation therapy, including dose fractionation and treatment volumes, simulation and treatment planning, and prevention of radiation-associated toxicities. Recommendations were based on a systematic literature review and created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength. Results: The guideline conditionally recommends conventionally fractionated or stereotactic body radiation for neoadjuvant and definitive therapy in certain patients and conventionally fractionated regimens for adjuvant therapy. The task force suggests a range of appropriate dose-fractionation schemes and provides recommendations on target volumes and sequencing of radiation and chemotherapy. Motion management, daily image guidance, use of contrast, and treatment with modulated techniques are all recommended. The task force supported prophylactic antiemetic medication, and patients may also benefit from medications to reduce acid secretion. Conclusions: The role of radiation in the management of pancreatic cancer is evolving, with many ongoing areas of active investigation. Radiation therapy is likely to become even more important as new systemic therapies are developed and there is increased focus on controlling local disease. It is important that the nuances of available data are discussed with patients and families and that care be coordinated in a multidisciplinary fashion. (Copyright © 2019 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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