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Options for unresectable tumor with SMV involvement

Pancreatic Cancer | Last Active: Aug 17 3:34pm | Replies (16)

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@steveron

Background:
To clarify: my wife is the patient, I am the researcher.
Our research discovered a clinical trial entitled "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". Here is the link:
https://www.thegreenjournal.com/article/S0167-8140(23)09371-4/fulltext
I am not a doctor, so the following is my layperson's understanding. SMART radiation uses real-time MRI imaging to adjust the beam as the patient's body moves for any number of reasons, such as during breathing. or muscle contraction. This is an improvement on traditional radiation which essentially takes a CT on Day 1 and uses that image for treatment on Day 2. Since this does not account for patient or tumor movement, the beam accuracy is reduced and more of the tumor is missed and other tissues are radiated. SMART provides more accuracy and therefore allows higher dosage. SMART takes two weeks. Week 1 Day 1 is consult to plan the treatment. There are 5 days of radiation in Week 2 followed by recovery.

Here is a link to Dr. Michael Chuong at Miami Baptist Health, who was the study leader:
https://baptisthealth.net/doctors/michael-d-chuong/869551
We traded emails and spoke with him at length by phone. He was easy to speak with and answered all our questions. He said his treatment was specifically applicable to unresectable tumors because resectable patients would have Whipple surgery. We did not proceed with him as we thought Whipple surgery would be successful.

Dr. Percy Lee at City of Hope Los Angeles was also on the study team. We have a consultation with him on 8-14 as he is closer to our San Diego home than Miami and was recommended by Dr. Chuong. Here is his link:
https://www.cityofhope.org/percy-lee
Here is one patient's story:
https://baptisthealth.net/baptist-health-news/she-defeated-pancreatic-cancer-via-most-advanced-radiation-therapy-at-miami-cancer-institute
SCINTIX uses PET imaging, but not yet for PC.
https://scintixtherapy.com/education/
Clinical trials may be available, but we haven't investigated them in detail yet.

Let us know what you discover. Best wishes for success.

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Replies to "Background: To clarify: my wife is the patient, I am the researcher. Our research discovered a..."

If I may ask, how is this different from SBRT?

SBRT has been recommended S a next step for me so I have spent time with interventional radiologist to understand the process. I chose to enter a clinical trial first, but do feel this is a good back up plan.

steveron, I am eagerly awaiting updates from you after your visit with Dr. Lee. My case is similar and after reading your post and the patient's story from baptisthealth, I contacted Dr. Chuong. He was quick to respond and I am now waiting for new scan I have scheduled next week before following up with him.

I do hope your wife is getting some hopeful news; I belong to a couple of local PC support groups here that have been very helpful in giving me hope that this hideous disease is become much more manageable if not curable!
-Becky in Phoenix