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@ARTICLE{Elkhamisy:278406,
      author       = {S. A. Elkhamisy and C. Valentini and A. Lattermann and G.
                      Radhakrishna and L. A. Künzel and S. Löck$^*$ and E. G. C.
                      Troost$^*$},
      title        = {{N}ormo- or {H}ypo-{F}ractionated {P}hoton or {P}roton
                      {R}adiotherapy in the {M}anagement of {L}ocally {A}dvanced
                      {U}nresectable {P}ancreatic {C}ancer: {A} {S}ystematic
                      {R}eview.},
      journal      = {Cancers},
      volume       = {15},
      number       = {15},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2023-01640},
      pages        = {3771},
      year         = {2023},
      abstract     = {LAPC is associated with a poor prognosis and requires a
                      multimodal treatment approach. However, the role of
                      radiation therapy in LAPC treatment remains controversial.
                      This systematic review aimed to explore the role of proton
                      and photon therapy, with varying radiation techniques and
                      fractionation, in treatment outcomes and their respective
                      toxicity profiles.Clinical studies published from 2012 to
                      2022 were systematically reviewed using PubMed, MEDLINE (via
                      PubMed) and Cochrane databases. Different
                      radiotherapy-related data were extracted and analyzed.A
                      total of 31 studies matched the inclusion criteria. Acute
                      toxicity was less remarkable in stereotactic body
                      radiotherapy (SBRT) compared to conventionally fractionated
                      radiotherapy (CFRT), while in proton beam therapy (PBT)
                      grade 3 or higher acute toxicity was observed more commonly
                      with doses of 67.5 Gy (RBE) or higher. Late toxicity was not
                      reported in most studies; therefore, comparison between
                      groups was not possible. The range of median overall
                      survival (OS) for the CFRT and SBRT groups was 9.3-22.9
                      months and 8.5-20 months, respectively. For the PBT group,
                      the range of median OS was 18.4-22.3 months.CFRT and SBRT
                      showed comparable survival outcomes with a more favorable
                      acute toxicity profile for SBRT. PBT is a promising new
                      treatment modality; however, additional clinical studies are
                      needed to support its efficacy and safety.},
      subtyp        = {Review Article},
      keywords     = {SBRT (Other) / locally advanced pancreatic adenocarcinoma
                      (Other) / photon therapy (Other) / proton beam therapy
                      (Other) / systematic review (Other)},
      cin          = {DD01},
      ddc          = {610},
      cid          = {I:(DE-He78)DD01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37568587},
      pmc          = {pmc:PMC10416887},
      doi          = {10.3390/cancers15153771},
      url          = {https://inrepo02.dkfz.de/record/278406},
}