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Clinical Limitations of Photon, Proton and Carbon Ion Therapy for Pancreatic Cancer

1
Cancer Research Institute and School of Health Sciences, University of South Australia, Adelaide SA 5001, Australia
2
Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide SA 5000, Australia
3
School of Engineering, University of South Australia, Adelaide SA 5001, Australia
4
Department of Physics, University of Adelaide, Adelaide SA 5005, Australia
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(1), 163; https://doi.org/10.3390/cancers12010163
Received: 18 December 2019 / Revised: 3 January 2020 / Accepted: 6 January 2020 / Published: 9 January 2020
(This article belongs to the Special Issue Targeted Cancer Therapy)
Introduction: Despite improvements in radiation therapy, chemotherapy and surgical procedures over the last 30 years, pancreatic cancer 5-year survival rate remains at 9%. Reduced stroma permeability and heterogeneous blood supply to the tumour prevent chemoradiation from making a meaningful impact on overall survival. Hypoxia-activated prodrugs are the latest strategy to reintroduce oxygenation to radioresistant cells harbouring in pancreatic cancer. This paper reviews the current status of photon and particle radiation therapy for pancreatic cancer in combination with systemic therapies and hypoxia activators. Methods: The current effectiveness of management of pancreatic cancer was systematically evaluated from MEDLINE® database search in April 2019. Results: Limited published data suggest pancreatic cancer patients undergoing carbon ion therapy and proton therapy achieve a comparable median survival time (25.1 months and 25.6 months, respectively) and 1-year overall survival rate (84% and 77.8%). Inconsistencies in methodology, recording parameters and protocols have prevented the safety and technical aspects of particle therapy to be fully defined yet. Conclusion: There is an increasing requirement to tackle unmet clinical demands of pancreatic cancer, particularly the lack of synergistic therapies in the advancing space of radiation oncology. View Full-Text
Keywords: pancreatic cancer; proton therapy; carbon ion therapy; stereotactic body radiation therapy; hypoxia activated prodrug; radiosensitizer pancreatic cancer; proton therapy; carbon ion therapy; stereotactic body radiation therapy; hypoxia activated prodrug; radiosensitizer
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Dell’Oro, M.; Short, M.; Wilson, P.; Bezak, E. Clinical Limitations of Photon, Proton and Carbon Ion Therapy for Pancreatic Cancer. Cancers 2020, 12, 163.

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