Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
Reviewer: Eric Shinohara MD, MSCI
Abramson Cancer Center of the University of Pennsylvania
Ultima Vez Modificado: 28 de mayo del 2008
Presenter: Mark Ingram
Presenter's Affiliation: University of Pennsylvania
Type of Session: Poster
Materials and Methods
Comprehensive nodal irradiation included the porta-hepatic, celiac, superior mesenteric, and peri-pancreatic nodal regions.
Plans were calculated using the Eclipse Proton Convolution Superposition algorithm.
Plans were done using a scatter beam system supplied by Ion Beam Applications (IBA) proton therapy systems.
Compensators and blocks were used to increase conformality with the target volume.
Pancreatic cancer has an extremely poor prognosis and local recurrences are a major problem. Local control is important not only in the curative setting but also in the palliative setting to prevent pain syndromes due to celiac axis invasion. However, concurrent chemoradiation can be quite toxic and without proper nutritional and fluid support it can be difficult for patients to complete treatment without interruptions. By increasing the conformality of radiation therapy it may be possible to decrease the dose to normal tissues, decreasing toxicity. Additionally, it may allow the dose of radiation used to be increased, improving local control. It may also allow the concurrent use of chemotherapeutics which have a radiosensitizing effect such as Gemzar, which is only rarely used due to combined toxicity. However, with less normal tissue being irradiated it may be possible to deliver radiation concurrently and safely with such agents, which may improve the local effects of radiation as well as decrease distant failures. We may see even less normal tissue toxicity with the use of scanning beam protons and intensity modulated proton therapy (IMPT).
However, clearly greater conformality comes with risks, the most significant being margin misses. There is still breathing motion which must be accounted for in the treatment of pancreatic cancer and with protons, this will become even more important to account for. Clearly clinical trials are needed and as more proton facilities become available these will hopefully move forward.
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