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What type of patients with lesions of the pancreas and spine are suitable candidates for treatment with the CyberKnife robotic radiosurgical system?

Published online by Cambridge University Press:  16 May 2013

Stuart McCaighy
Stuart McCaighy*
Affiliation:
The London Clinic, London, UK
*
Correspondence to: Stuart McCaighy, The London Clinic, London, UK. Tel: 0203 219 3532. E-mail: xqi@mednet.ucla.edu
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Abstract

Materials & methods

A systematic literature review was conducted to critically examine patient selection for patients undergoing stereotactic body radiotherapy (SBRT) to the spine and pancreas on the CyberKnife robotic radiosurgical system (CK). Online databases were searched and data was collected and ranked using a system from the Scottish Intercollegiate Guideline Network. The quality of the evidence analysed was insufficient to generate universal recommendations. However, the conclusions reached do help to demonstrate the safety and efficacy of CK treatment to both pancreatic and spinal patients.

Results

Excellent local control rates and minimal acute toxicity were reported within the spinal literature with uncertainties remaining with regard to the precise tolerance of the spinal cord and the reliability of current toxicity prediction methods. For pancreatic patients prognosis remains dismal due to the tendency for patients to present with advanced or inoperable disease. Combinations of CK SBRT and Gemcitabine chemotherapy are given though regimes vary and overall survival is not extended due to the rapid onset of distant metastases. New chemotherapy agents are required as well as better means of predicting response to treatment.

Conclusion

No randomised controlled trials or meta-analyses were identified in the review and these are required in order to generate universal guidelines

Keywords

CyberKnifepancreasspinestereotactic body radiotherapy
Type
Literature Review
Information
Journal of Radiotherapy in Practice , Volume 13 , Issue 1 , March 2014 , pp. 106 - 114
Copyright
Copyright © Cambridge University Press 2013 

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