Trial reportRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2024
Stereotactic MR-guided on-table adaptive radiation therapy (SMART) for borderline resectable and locally advanced pancreatic cancer: A multi-center, open-label phase 2 study.
Trial report in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03621644 (Prospective Phase II Study of Stereotactic Magnetic Resonance Imaging), which is not on this map. Cited by 57 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Phase II Study of Stereotactic Magnetic Resonance Imaging (MRI) Guided On-table Adaptive Radiation Therapy (SMART) for Patients With Borderline or Inoperable Locally Advanced Pancreatic Cancer
Who cites it
57 citing papers in PubMed, 96 citations in OpenAlex.
- Prospective Phase 2 Clinical Trial of Carbon Ion Radiation Therapy Combined With Chemotherapy for Locally Advanced Pancreatic Carcinoma.International journal of radiation oncology, biology, physics · 2025Trial
- Trial
- Challenges and opportunities in combining radiotherapy and immunotherapy for localized pancreatic cancer.Nature reviews. Gastroenterology & hepatology · 2026Review
- Online adaptive radiotherapy: International strategies for AI-enabled workflow efficiency and radiation therapist-led delivery for sustainable practice.Technical innovations & patient support in radiation oncology · 2026Article
- Global hotspots and trends of stereotactic radiotherapy for pancreatic cancer: a bibliometric analysis and visual analysis from 2015 to 2025.Translational cancer research · 2026Article
- Evaluating the role of plan complexity metrics in online adaptive radiotherapy for pancreatic cancer patients.Medical physics · 2026Article
- Article
- Best Practice: CT-guided Adaptive Radiotherapy Reference Planning on the Ethos Platform.Journal of applied clinical medical physics · 2026Review
- Article
- Imaging Biomarkers in Radiotherapy.Cancers · 2026Review
- Terminology Proposal for Adaptive Particle Therapy Classification and Strategies.International journal of particle therapy · 2026Article
- Favorable histo-molecular remodeling of pancreatic ductal adenocarcinoma after neoadjuvant FOLFIRINOX followed by high-dose stereotactic body radiotherapy.British journal of cancer · 2026Article
- Pancreatic SBRT on four modern platforms: dosimetric and radiobiological gains with the Ethos ring-gantry linac versus TrueBeam, Halcyon, and helical tomotherapy.Radiation oncology (London, England) · 2026Article
- Stereotactic Adaptive Radiation Therapy for Borderline Resectable or Locally Advanced Pancreatic Cancer to Minimize Gastrointestinal Toxicity (ARTIA-Pancreas): Protocol for a Single-Arm Prospective Trial.JMIR research protocols · 2026Article
- Immune Stromal Components Impede Biological Effectiveness of Carbon Ion Therapy in a Preclinical Model of Pancreatic Ductal Adenocarcinoma.Molecular cancer therapeutics · 2026Article
- Balancing dose preservation and treatment efficiency in motion-managed magnetic resonance image-guided radiotherapy of pancreatic cancer.Physics and imaging in radiation oncology · 2026Article
- Radiotherapy in the management of PDAC, from past to present.Translational oncology · 2026Review
- Patient-specific fine-tuning of a self-distilled transformer model for normal tissue segmentation in abdominal magnetic resonance guided adaptive radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Radiotherapy as a partner for immunotherapy in pancreatic cancer: current landscape and future directions.Frontiers in oncology · 2026Review
- Ablative stereotactic MR-guided radiotherapy for >10 cm solid pseudopapillary tumor of the pancreas with liver oligometastases: a case report and literature review.Frontiers in oncology · 2026Article
Corrections and comments
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Authors and funding
30 authors at 16 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeRadiation dose escalation may improve local control (LC) and overall survival (OS) in select pancreatic ductal adenocarcinoma (PDAC) patients. We prospectively evaluated the safety and efficacy of ablative stereotactic magnetic resonance (MR)-guided adaptive radiation therapy (SMART) for borderline resectable (BRPC) and locally advanced pancreas cancer (LAPC). The primary endpoint of acute grade ≥ 3 gastrointestinal (GI) toxicity definitely related to SMART was previously published with median follow-up (FU) 8.8 months from SMART. We now present more mature outcomes including OS and late toxicity. MATERIALS AND
methodsThis prospective, multi-center, single-arm open-label phase 2 trial (NCT03621644) enrolled 136 patients (LAPC 56.6 %; BRPC 43.4 %) after ≥ 3 months of any chemotherapy without distant progression and CA19-9 ≤ 500 U/mL. SMART was delivered on a 0.35 T MR-guided system prescribed to 50 Gy in 5 fractions (biologically effective dose
resultsMean age was 65.7 years (range, 36-85), induction FOLFIRINOX was common (81.7 %), most received elective coverage (57.4 %), and 34.6 % had surgery after SMART. Median FU was 22.9 months from diagnosis and 14.2 months from SMART, respectively. 2-year OS from diagnosis and SMART were 53.6 % and 40.5 %, respectively. Late grade ≥ 3 toxicity definitely, probably, or possibly attributed to SMART were observed in 0 %, 4.6 %, and 11.5 % patients, respectively.
conclusionsLong-term outcomes from the phase 2 SMART trial demonstrate encouraging OS and limited severe toxicity. Additional prospective evaluation of this novel strategy is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.