ArticleRadiation oncology (London, England)2021
Surgical spacer placement for proton radiotherapy in locally advanced pancreatic body and tail cancers: initial clinical results.
Article in Radiation oncology (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 25 citations in OpenAlex.
- Endoscopic Spacer-Assisted Stereotactic Body Radiation Therapy for Abdominal Oligometastases: A Novel Technique to Reduce Gastrointestinal Toxicity.Advances in radiation oncology · 2026Article
- Laparoscopic omentopexy as a spacer for carbon-ion radiotherapy in locally advanced pancreatic cancer.Annals of hepato-biliary-pancreatic surgery · 2025Article
- Combination Treatment with Spacer Placement Surgery Followed by Particle Radiotherapy for Lymph Node Metastasis from Uterine Cancer.Annals of surgical oncology · 2025Article
- Protecting organs-at-risk in cancer therapies through temporary organ displacement: a comprehensive review.Oncology reviews · 2025Review
- Clinical impact of spacer placement surgery with expanded polytetrafluoroethylene sheet for particle therapy.Radiation oncology (London, England) · 2023Article
- Proton radiotherapy as a treatment strategy to increase survival in locally advanced pancreatic cancer in the body and tail: a retrospective study.Radiation oncology (London, England) · 2023Article
- Article
- Laparoscopic spacer placement for bulky lymph node metastasis of cervical cancer: A case report.Gynecologic oncology reports · 2022Article
- Demonstrating the benefits of corrective intraoperative feedback in improving the quality of duodenal hydrogel spacer placement.Medical physics · 2022Article
- Proton Therapy in the Management of Pancreatic Cancer.Cancers · 2022Review
- Factors associated with long-term survival in gemcitabine-concurrent proton radiotherapy for non-metastatic locally advanced pancreatic cancer: a single-center retrospective study.Radiation oncology (London, England) · 2022Article
- Finite Element-Based Personalized Simulation of Duodenal Hydrogel Spacer: Spacer Location Dependent Duodenal Sparing and a Decision Support System for Spacer-Enabled Pancreatic Cancer Radiation Therapy.Frontiers in oncology · 2022Article
- A Female With Synchronous Multiple Primary Malignant Tumors in the Esophagogastric Junction, Duodenum and Pancreas: Case Report and Review of the Literature.Frontiers in oncology · 2022Article
- Practice-oriented solutions integrating intraoperative electron irradiation and personalized proton therapy for recurrent or unresectable cancers: Proof of concept and potential for dual FLASH effect.Frontiers in oncology · 2022Article
Corrections and comments
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Authors and funding
15 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundParticle radiotherapy has increasingly gained acceptance for locally advanced pancreatic cancers owing to superior tumor conformity and dosimetry compared to conventional photon radiotherapy. However, the close proximity of the pancreas to the stomach and duodenum leads to radiation-induced gastrointestinal toxicities, which hinder the delivery of curative doses to the tumor. To overcome this problem, a surgical spacer was placed between the tumor and gastrointestinal tract, and subsequent proton radiotherapy was performed in this study.
methodsData from 9 patients who underwent surgical spacer placement and subsequent proton radiotherapy were analyzed. The safety and feasibility of the spacer placement surgery were evaluated; the impact of the spacer on dosimetry was also assessed using dose volume histogram (DVH) analyses, before and after surgical spacer placement.
resultsSurgical spacer placement and subsequent proton radiotherapy were successfully completed in all cases. Surgical spacer placement significantly improved the dose intensity covering 95%, mean, and minimum doses for the gross tumor volume, and the clinical and planning target volume based on the DVH, while respecting the dose constraints of the gastrointestinal tract. Based on the Common Terminology Criteria for Adverse Events, two patients (22.2%) developed gastrointestinal ulcer (Grade 2) at 1 and 35 months, and one patient (11.1%) developed gastric perforation (Grade 4) at 4 months after proton radiotherapy.
conclusionsSurgical spacer placement in the locally advanced pancreatic body and tail cancers is relatively safe and technically feasible. Comparing radiation plans, surgical spacer placement seems to improve the dose distribution in the locally advanced pancreatic body and tail cancers, which are close to the gastrointestinal tract.
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