Abstract
The role of external beam radiation therapy (EBRT) in the management of upper gastrointestinal malignancies is constantly evolving. As radiation therapy techniques improve and are able to deliver more ablative doses of radiotherapy while sparing healthy tissue, radiation can be applied to a wider range of clinical scenarios. Stereotactic body radiation therapy (SBRT) allows a high dose of radiation to be delivered to a highly conformal treatment volume in a short amount of time. Another potential advantage of SBRT is its ability to increase tumor immunogenicity, while also having less of an immunosuppressive effect on the patient, as compared to conventionally fractionated radiation therapy. In so doing, SBRT may potentiate the effects of immune therapy when the two treatments are combined, thus improving therapeutic outcomes. This article provides an overview of the role of SBRT in the management of upper gastrointestinal GI malignancies and the emerging data on immune biomarkers and SBRT, with a focus on pancreatic and liver cancer.
Highlights
The role of external beam radiation therapy in the management of upper gastrointestinal (GI)malignancies is constantly evolving
A meta-analysis of 19 trials of Stereotactic body radiation therapy (SBRT) for locally advanced unresectable pancreatic cancer (LAPC) published in 2017 showed that the median overall survival was greater than 12 months in the vast majority of studies and was favorable in the subset of patients who became resectable after receiving SBRT [20]
It allows for more curative doses of radiation to be delivered to a highly conformal treatment volume, in a short amount of time, allowing for effective and expedited treatment for these highly aggressive malignancies
Summary
The role of external beam radiation therapy in the management of upper gastrointestinal (GI). Stereotactic body radiation therapy (SBRT) is a technique that allows a high dose of radiation to be delivered to a highly conformal treatment volume in a short amount of time This results in a number of advantages. This article seeks to review the role of SBRT in the management of upper GI malignancies with a focus on pancreatic and liver cancer. Another potential advantage of SBRT is its ability to increase tumor immunogenicity while having less of an immunosuppressive effect on the patient, as compared to conventionally fractionated radiation therapy [2]. Biomedicines 2018, 6, 7 tumor biomarkers and SBRT is in its infancy, it is hypothesis-generating and will be reviewed in this article
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