1017 / 1578
/
Study
Patients Toxicity
Hoyer 2005
Phase II
22
5 cases with severe GI tox
Koong 2005
Phase II
17
2/17 acute G3 GI
Schellenberg
2008
Phase II
16
Late:
5x G2 ulcers
1x G3 duodenal stenosis
1x G4 duodenal
perforation
Schellenberg
2011
Phase II
20
3x G2 ulcers
1x G4 duodenal
perforation
SBRT for locally advanced pancreatic cancer
Ø
(Very) high rates of GI toxicity DESPITE short FU
Ø
Difficult (impossible) sparing of duodenum
ESTRO SBRT 2017 - Matthias Guckenberger
11
/
Duodenal toxicity - dose constraints
Issues:
• Validation, motion, short FU, chemotherapy, …
Goldsmith Sem Radiat Oncol 2016
ESTRO SBRT 2017 - Matthias Guckenberger
12