Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Aug 21;21(31):9420-9.
doi: 10.3748/wjg.v21.i31.9420.

Robotic radiosurgery in pancreatic cancer: A systematic review

Milly Buwenge  1 , Francesco Cellini  1 , Nicola Silvestris  1 , Savino Cilla  1 , Francesco Deodato  1 , Gabriella Macchia  1 , Gian C Mattiucci  1 , Vincenzo Valentini  1 , Alessio G Morganti  1
Affiliations

Robotic radiosurgery in pancreatic cancer: A systematic review

Milly Buwenge et al. World J Gastroenterol. .

Abstract

Aim: To present a systematic review of techniques and clinical results.

Methods: A systematic review of published literature was performed. Only studies reporting patient outcome after radiosurgery (single fraction) delivered with robotic devices [i.e., robotic radiosurgery (RRS)] have been analyzed.

Results: A total of 96 patients from 5 studies were included. The studies are characterized by small series and different methods in terms of dose, target definition, combination with chemotherapy and/or standard fractionated radiotherapy and evaluation modalities. Preliminary results are positive in terms of tumor response (ORR = 56%) and local control of the tumor (crude rate of local progressions: 19.5%). Results for median overall survival (11.4 mo) seem comparable with the ones of prolonged chemoradiation (range: 8.6-13.0 mo). However, gastrointestinal toxicity seems to be the main limitation of RRS, especially at the duodenal level.

Conclusion: RRS allows for local treatment in a shortened time (1 fraction) compared to traditional treatments (about 1 mo), providing the possibility for an easy integration with systemic therapies. Preliminary results did not show any outcome differences compared to standard chemoradiation. Thus, further efforts to reduce gastrointestinal toxicity are strongly needed.

Keywords: Pancreas; Pancreatic neoplasms; Radiosurgery; Review; Robotic; Stereotactic radiotherapy; Systematic review.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Process of paper selection. Evaluated studies (35); Excluded studies (30); Included studies (5). 1Studies excluded because they did not individuate all the inclusion criteria after collegial evaluation of the full-text manuscript.
See this image and copyright information in PMC

References

    1. Hishinuma S, Ogata Y, Tomikawa M, Ozawa I, Hirabayashi K, Igarashi S. Patterns of recurrence after curative resection of pancreatic cancer, based on autopsy findings. J Gastrointest Surg. 2006;10:511–518. - PubMed
    1. Kayahara M, Nagakawa T, Ueno K, Ohta T, Takeda T, Miyazaki I. An evaluation of radical resection for pancreatic cancer based on the mode of recurrence as determined by autopsy and diagnostic imaging. Cancer. 1993;72:2118–2123. - PubMed
    1. Morganti AG, Massaccesi M, La Torre G, Caravatta L, Piscopo A, Tambaro R, Sofo L, Sallustio G, Ingrosso M, Macchia G, et al. A systematic review of resectability and survival after concurrent chemoradiation in primarily unresectable pancreatic cancer. Ann Surg Oncol. 2010;17:194–205. - PubMed
    1. Morganti AG, Trodella L, Valentini V, Barbi S, Macchia G, Mantini G, Turriziani A, Cellini N. Pain relief with short-term irradiation in locally advanced carcinoma of the pancreas. J Palliat Care. 2003;19:258–262. - PubMed
    1. Valentini V, Morganti AG, Macchia G, Mantini G, Mattiucci GC, Brizi MG, Alfieri S, Bossola M, Pacelli F, Sofo L, et al. Intraoperative radiation therapy in resected pancreatic carcinoma: long-term analysis. Int J Radiat Oncol Biol Phys. 2008;70:1094–1099. - PubMed

Publication types

MeSH terms