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Radiation Therapy

There have been vast improvements in the delivery of radiation therapy for cancer patients over the past 10 years. Radiation therapy is more focused to treat the primary tumor, while limiting radiation exposure to normal, adjacent tissue. The machines used today employ multiple beams of radiation, directed at different angles to different parts of the body. Modern radiation techniques allow for movement in the abdomen while a patient breathes and can better target the tumors during that motion.

Contrary to some patients’ beliefs or fears, radiation therapy is unlikely to burn the skin, to leave red marks, or cause skin toxicity. And, similar to an X-ray, the treatment does not cause pain when administered and will not leave patients radioactive.

Standard, conventional radiation therapy is delivered Monday through Friday, once a day, over a five- to six-week period. The treatment takes approximately 15-20 minutes, or up to an hour. Most patients receiving radiation therapy are given chemotherapy in the same time frame.  

In some cases, Johns Hopkins experts offer palliative radiation therapy. This treatment is typically given over a two-week period and is used to relieve pain for patients or slow local tumor growth.

Radiation therapy services, offered through the Department of Radiation Oncology, provides a wide variety of pancreative cancer therapies and expert consultation.

Stereotactic body radiation therapy (SBRT)

Stereotactic body radiation therapy (SBRT) is a form of focused radiation used successfully to treat brain and lung cancers. CyberKnife, a type of stereotactic body radiation therapy, uses a robotic arm to deliver radiation in a number of different ways and at and at different angles. More recently focused radiation has been touted as a promising new treatment for pancreas cancer, causing confusion among patients and concern among physicians. Why the concern? Johns Hopkins experts say currently there is little evidence to show that stereotactic radiotherapy can shrink pancreas tumors or improve survival.

Stereotactic body radiation therapy and CyberKnife use high doses of precisely targeted beams of radiation instead of scalpels to cut through tumors and kill cancer cells. It can be a valuable tool in treating cancer as these targeted beams can reach tumors that are inaccessible by traditional surgical means, but it is not for every cancer, according to experts. Higher doses of radiation can mean greater toxic side effects to normal tissue. Johns Hopkins is among the leading innovators of new technologies, and our experts are leading the way in collecting and analyzing data from our patients and other institutions to determine the safety and effectiveness of these new medical technologies.

Less is More: A Closer Look at Stereotactic Body Radiation Therapy for Pancreas Cancer

More is not always better, particularly in radiation oncology, according to Johns Hopkins experts. Higher doses of radiation can cause serious side effects to normal cells.

A team of Kimmel Cancer Center clinician scientists are collaborating with investigators at Memorial Sloan Kettering Cancer Center and Stanford University to study stereotactic radiotherapy approaches for pancreas cancer. They want to find out if a high dose of stereotactic radiation therapy delivered over one to five days could lead to fewer side effects and be as effective as the standard radiation treatment, which is delivered over a five-week period along with chemotherapy.

In early studies, patients were treated with one day of radiation therapy to the pancreas and a small amount of surrounding tissue. The high-dose approach can cause unpleasant and sometimes dangerous bowel toxicities and other side effects in 30 to 40 percent of patients treated. By lowering the dose of radiation each day but extending the treatment to five days, the therapeutic benefits for pancreas cancer patients could persist while decreasing side effects and improving quality of life.

Further studies and longer term followup are needed to confirm these early results. The next step will be to combine novel drugs and vaccines with stereotactic radiotherapy to try and augment its ability to kill cancer cells.

 

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