Table 1.
Study and treatment characteristics
Ref. | Study design | Inclusion criteria | Simulation | PTV | Image guidance | Dose prescription | Radiotherapy dose, median (range) | % of patients receiving chemotherapy |
Koong et al[17], 2004 | Phase I | LA; < 7.5 cm1 | Pancreatic protocol CT | NR | Fiducials tracking | To isodose surrounding PTV | 20 Gy SF RRS | 6.6 before RRS |
Koong et al[18], 2005 | Phase II | LA | Pancreatic protocol CT | NR | Mid-breath-hold or fiducials tracking | To isodose surrounding PTV | 45 Gy in 1.8 Gy/fr (IMRT) +; 25 Gy SF RRS boost | 100.0 concurrent to IMRT: 5-FU or CAP |
Schellenberg et al[19], 2008 | Case serie | LA | End-expiration biphasic CT + respiratory gated CT + PET-CT | PTV: GTV + 2-3 mm | Fiducials tracking | To isodose surrounding PTV | 25 Gy SF RRS | 100.0 1 cycle GEM pre-RRS; 0-8 cycles GEM post-RRS |
Seo et al[20], 2009 | Phase I | LA; no duodenal invasion; < 3 N+ | CT + PET-CT (restricted respiratory motion) | PTV: GTV + 2 mm, or 4 mm cranio-caudally | Fiducials tracking | To isodose covering 97% of PTV | 40 Gy in 2 Gy/fr (3D-CRT) + 16.5 Gy (14-17) SF RRS boost | 70.0 (6 before RT; 15 concurrent to 3D-CRT) |
Goyal et al[21], 2012 | Case serie | LA | CT + MRI ± PET-CT | NR | Fiducial tracking | To 70% isodose | 14 pts: 25 (20-25) SF RRS 5 pts: 3 fractions (24-30) | 68% before RRS (various schedules) |
Two patients received previous radiotherapy. 3D-CRT: 3D-conformal radiation therapy; 5-FU: 5-fluorouracil; GEM: Gemcitabine; GTV: Gross tumor volume; IMRT: Intensity modulated radiation therapy; LA: Locally advanced; NR: Not reported; PTV: Planning target volume; RRS: Robotic radiosurgery; SF: Single fraction.