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Epitranscriptomics & Cancer Adaptation : A.David

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Item Type Journal Article
Title Stereotactic MR-Guided Adaptive Radiotherapy for Pancreatic Tumors: Updated Results of the Montpellier Prospective Registry Study
Creator Bordeau et al.
Author Karl Bordeau
Author Morgan Michalet
Author Aïcha Keskes
Author Simon Valdenaire
Author Pierre Debuire
Author Marie Cantaloube
Author Morgane Cabaillé
Author Fabienne Portales
Author Roxana Draghici
Author Marc Ychou
Author Eric Assenat
Author Thibault Mazard
Author Emmanuelle Samalin
Author Ludovic Gauthier
Author Pierre-Emmanuel Colombo
Author François-Régis Souche
Author Pascal Fenoglietto
Author David Azria
Author Olivier Riou
Abstract Introduction: Stereotactic MR-guided Adaptive RadioTherapy (SMART) is a novel process to treat pancreatic tumors. We present an update of the data from our prospective registry of SMART for pancreatic tumors. Materials and methods: After the establishment of the SMART indication in a multidisciplinary board, we included all patients treated for pancreatic tumors. Primary endpoints were acute and late toxicities. Secondary endpoints were survival outcomes (local control, overall survival, distant metastasis free survival) and dosimetric advantages of adaptive process on targets volumes and OAR. Results: We included seventy consecutive patients in our cohort between October 2019 and April 2022. The prescribed dose was 50 Gy in 5 consecutive fractions. No severe acute SMART related toxicity was noted. Acute and late Grade ? 2 gastro intestinal were low. Daily adaptation significantly improved PTV and GTV coverage as well as OAR sparing. With a median follow-up of 10.8 months since SMART completion, the median OS, 6-months OS, and 1-year OS were 20.9 months, 86.7% (95% CI: (75?93%), and 68.6% (95% CI: (53?80%), respectively, from SMART completion. Local control at 6 months, 1 year, and 2 years were, respectively, 96.8 % (95% CI: 88?99%), 86.5 (95% CI: 68?95%), and 80.7% (95% CI: 59?92%). There was no grade > 2 late toxicities. Locally Advanced Pancreatic Cancers (LAPC) and Borderline Resectable Pancreatic Cancers (BRPC) patients (52 patients) had a median OS, 6-months OS, and 1-year OS from SMART completion of 15.2 months, 84.4% (95% CI: (70?92%)), and 60.5% (95% CI: (42?75%)), respectively. The median OS, 1-year OS, and 2-year OS from initiation of induction chemotherapy were 22.3 months, 91% (95% CI: (78?97%)), and 45.8% (95% CI: (27?63%)), respectively. Twenty patients underwent surgical resection (38.7 % of patients with initially LAPC) with negative margins (R0). Conclusion: To our knowledge, this is the largest series of SMART for pancreatic tumors. The treatment was well tolerated with only low-grade toxicities. Long-term OS and LC rates were achieved. SMART achieved high secondary resection rates in LAPC patients.
Publication Cancers
Volume 15
Issue 1
Pages 7
Date 2022-12-20
Journal Abbr Cancers (Basel)
Language eng
DOI 10.3390/cancers15010007
ISSN 2072-6694
Short Title Stereotactic MR-Guided Adaptive Radiotherapy for Pancreatic Tumors
Library Catalog PubMed
Extra Number: 1 PMID: 36612004 PMCID: PMC9817834
Tags borderline resectable pancreatic cancers (BRPC), clinic, first-last-coresponding, locally advanced pancreatic cancer (LAPC), pancreas cancer, pancreatic tumors, stereotactic body radiation therapy (SBRT), stereotactic MR-guided adaptive radio therapy (SMART)
Date Added 2023/11/23 - 12:48:40
Date Modified 2024/12/15 - 03:57:49
Notes and Attachments PubMed entry (Attachment)
Texte intégral (Attachment)


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