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Pancreatic Neoplasms: HELP
Articles by Ursula Nestle
Based on 2 articles published since 2010
(Why 2 articles?)

Between 2010 and 2020, U. Nestle wrote the following 2 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Review SBRT in pancreatic cancer: what is the therapeutic window? 2015

Brunner, Thomas B / Nestle, Ursula / Grosu, Anca-Ligia / Partridge, Mike. ·Department of Radiation Oncology, University Hospitals Freiburg, Germany. Electronic address: Thomas.brunner@uniklinik-freiburg.de. · Department of Radiation Oncology, University Hospitals Freiburg, Germany. · CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, UK. ·Radiother Oncol · Pubmed #25466369.

ABSTRACT: PURPOSE/OBJECTIVE: To analyse outcome and toxicity of stereotactic body radiotherapy (SBRT) in pancreatic cancer (PDAC). MATERIAL/METHODS: We systematically reviewed full reports on outcome and toxicity transforming prescription doses to equivalent doses of 2 Gy (EQD2) and biological equivalent doses (BED). Pearson product-moment correlation coefficient, regression analysis and Lyman-Kutcher-Burman modelling were used. RESULTS: Sixteen trials (572 patients) were identified. Local control correlated with dose. Additionally 4 upper gastrointestinal-SBRT trials (149 patients) were included for toxicity analysis. Acute toxicity was mild but late toxicity ⩾G2 was substantial and predominantly gastrointestinal. Late toxicity ⩾G2 and ⩾G3 correlated highly with EQD2/BED after linear (R(2)=0.85 and 0.77, respectively) and Lyman-Kutcher-Burman modelling. Linear regression lines indicated ⩾G2 and ⩾G3 toxicity frequencies of 5% at 65 Gy and 80 Gy EQD2-α/β=3, respectively. A comparison of toxicity with dose constraints for duodenum revealed partly inadequate dose constraints. CONCLUSION: RESULTS from multiple fraction regimens could be successfully interpreted to estimate toxicity according to EQD2/BED prescription doses, and dose constraints for the duodenum were derived, whereas local control appeared to be less dose-dependent. This analysis may be useful to plan clinical trials for SBRT and hypofractionated radiotherapy in pancreatic cancer.

2 Clinical Trial Stereotactic body radiotherapy (SBRT) in recurrent or oligometastatic pancreatic cancer : A toxicity review of simultaneous integrated protection (SIP) versus conventional SBRT. 2017

Gkika, E / Adebahr, S / Kirste, S / Schimek-Jasch, T / Wiehle, R / Claus, R / Wittel, U / Nestle, U / Baltas, D / Grosu, A L / Brunner, T B. ·Department of Radiation Oncology, University Medical Center Freiburg, Robert-Koch-Str. 3, 79106, Freiburg im Breisgau, Germany. eleni.gkika@uniklinik-freiburg.de. · Department of Radiation Oncology, University Medical Center Freiburg, Robert-Koch-Str. 3, 79106, Freiburg im Breisgau, Germany. · German Cancer Consortium (DKTK), Heidelberg (partner site Freiburg), Germany. · Division of Medical Physics, Department of Radiation Oncology, University Medical Center Freiburg, Freiburg, Germany. · Department of Hematology, Oncology and Stem-Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany. · Department of General and Visceral Surgery, University Medical Center Freiburg, Freiburg, Germany. · Faculty of Medicine, University of Freiburg, Freiburg, Germany. ·Strahlenther Onkol · Pubmed #28138949.

ABSTRACT: BACKGROUND: Stereotactic body radiotherapy (SBRT) in pancreatic cancer can be limited by its proximity to organs at risk (OAR). In this analysis, we evaluated the toxicity and efficacy of two different treatment approaches in patients with locally recurrent or oligometastatic pancreatic cancer. MATERIALS AND METHODS: According to the prescription method, patients were divided in two cohorts (C1 and C2). The planning target volume (PTV) was created through a 4 mm expansion of the internal target volume. In C2, a subvolume was additionally created, a simultaneous integrated protection (SIP), which is the overlap of the PTV with the planning risk volume of an OAR to which we prescribed a reduced dose. RESULTS: In all, 18 patients were treated (7 with local recurrences, 9 for oligometastases, 2 for both). Twelve of 23 lesions were treated without SIP (C1) and 11 with SIP (C2). The median follow-up was 12.8 months. Median overall survival (OS) was 13.2 (95% confidence interval [CI] 9.8-14.6) months. The OS rates at 6 and 12 months were 87 and 58%, respectively. Freedom from local progression for combined cohorts at 6 and 12 months was 93 and 67% (95% CI 15-36), respectively. Local control was not statistically different between the two groups. One patient in C2 experienced grade ≥3 acute toxicities and 1 patient in C1 experienced a grade ≥3 late toxicity. CONCLUSION: The SIP approach is a useful prescription method for abdominal SBRT with a favorable toxicity profile which does not compromise local control and overall survival despite dose sacrifices in small subvolumes.