Robotic radiosurgery in pancreatic cancer: A systematic review

Table 1 Study and treatment characteristics

Ref.	Study design	Inclusion criteria	Simulation	PTV	Image guidance	Dose prescription	Radiotherapy dose, median (range)	% of patients receiving chemotherapy
Koong et al[17], 2004	Phase I	LA; < 7.5 cm1	Pancreatic protocol CT	NR	Fiducials tracking	To isodose surrounding PTV	20 Gy SF RRS	6.6 before RRS
Koong et al[18], 2005	Phase II	LA	Pancreatic protocol CT	NR	Mid-breath-hold or fiducials tracking	To isodose surrounding PTV	45 Gy in 1.8 Gy/fr (IMRT) +; 25 Gy SF RRS boost	100.0 concurrent to IMRT: 5-FU or CAP
Schellenberg et al[19], 2008	Case serie	LA	End-expiration biphasic CT + respiratory gated CT + PET-CT	PTV: GTV + 2-3 mm	Fiducials tracking	To isodose surrounding PTV	25 Gy SF RRS	100.0 1 cycle GEM pre-RRS; 0-8 cycles GEM post-RRS
Seo et al[20], 2009	Phase I	LA; no duodenal invasion; < 3 N+	CT + PET-CT (restricted respiratory motion)	PTV: GTV + 2 mm, or 4 mm cranio-caudally	Fiducials tracking	To isodose covering 97% of PTV	40 Gy in 2 Gy/fr (3D-CRT) + 16.5 Gy (14-17) SF RRS boost	70.0 (6 before RT; 15 concurrent to 3D-CRT)
Goyal et al[21], 2012	Case serie	LA	CT + MRI ± PET-CT	NR	Fiducial tracking	To 70% isodose	14 pts: 25 (20-25) SF RRS 5 pts: 3 fractions (24-30)	68% before RRS (various schedules)

¹Two patients received previous radiotherapy. 3D-CRT: 3D-conformal radiation therapy; 5-FU: 5-fluorouracil; GEM: Gemcitabine; GTV: Gross tumor volume; IMRT: Intensity modulated radiation therapy; LA: Locally advanced; NR: Not reported; PTV: Planning target volume; RRS: Robotic radiosurgery; SF: Single fraction.