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Abstract
Background/Aims
CyberKnife TM stereotactic body radiotherapy (SBRT) has been thought as a promising treatment modality for inoperable or recurred pancreaticobiliary malignancies. But, clinical course of CyberKnife TM treatment have not been established yet, so we report the experience of CyberKnife TM treatment in 19 patients with recurred or advanced pancreaticobilliary malignancies.
Methods
Between July 2008 and May 2009, 19 patients (gallbladder cancer 4, common bile duct cancer 5, and pancreatic cancer 10) with recurred (12) and advanced pancreaticobiliary cancer (7) underwent CyberKnife TM treatment in Soonchunhyang University Hospital. Tumor size was evaluated at 1, 3, 6, 8 and every 3 months after SBRT.
Results
The mean age was 60.2 years, and the mean size of target lesions was 28.1±1.30 mm. After CyberKnife TM treatment, the average size of target lesions was decreased; 2.53±4.18 mm from months 0–1 in 19 patients, 2.47±4.7 mm from months 1–3 in 15 patients, 0.08±5.11 mm from months 3–6 in 12 patients. However, the average size of target lesions was increased 3.67±8.98 mm from months 6–8 in 6 patients. There were 2 cases of massive duodenal ulcer bleeding after CyberKnife TM treatment, one of them expired due to ulcer bleeding. Also, other minor complications appeared such as 1 case of abdominal pain and 1 case of diarrhea.
Conclusions
CyberKnife TM treatment seems to be effective in local control of pancreaticobiliary cancer, but we experienced serious complications. Further prospective studies will be needed for the proper evaluation of role of Cyberknife TM treatment in patients with advanced pancreaticobiliary malignancies.
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Fig. 1.
CT findings. (A) CT scan revealed 2.9 cm sized metastatic lymph node in portocaval space (arrow). (B) Follow up CT scan after 6 months of CyberKnife TM therapy showed nearly complete resolution of metastatic lymph node (arrow).
Fig. 3.
Response related to target organ in 12 patients. L/N, lymph node; GB, gallbladder; Post OP, postoperative; CBD, common bile duct.
Table 1.
Patient Characteristics
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