“The idea is to shrink the tumor away
from these blood vessels and make
surgery possible,” he says.
The pancreas is a six-inch gland
located in the abdomen, nestled among
the stomach, small intestine, liver,
spleen, gallbladder, and duodenum.
With traditional radiation treatment,
it is difficult to treat a tumor on
the pancreas without delivering
harmful doses of radiation to nearby
healthy organs. SBRT allows radiation
oncologists to focus narrowly on a spot
within the pancreas. “With this type
of technique, we’re able to limit the
critical organs getting doses beyond
their tolerance,” Dr. Pahlajani says.
Innovation a nd patient success
SBRT was used to treat tumors on the
brain (where it is called stereotactic
radiosurgery), and on the lungs and
liver before physicians first began
using it on the pancreas. However,
the treatment remains novel for
patients with pancreatic cancer,
as few centers in the country are
using it. Dr. Pahlajani was recruited
to Scott & White Medical Center -
Temple in January 2016 to develop an
abdominal SBRT program, to include
the pancreas. “This is still something
that is in its infancy,” he says. As the
treatment becomes more common,
he predicts better outcomes for those
suffering from pancreatic cancer.
“We’ll see shifts in the remission rates
pretty soon once this technique gains
popularity,” he says. “It’s going to
make a difference.”
It already has made a difference
Although pancreatic cancer is a particularly deadly cancer, it is not a
common one. About 45,000 new cases of pancreatic cancer are diagnosed
in the United States each year. Fortunately, Scott & White Medical Center-
Temple is able to offer SBRT because it has the high patient volumes and
physicians experienced in providing the latest, best treatments to patients
with pancreatic cancer. Dr. Pahlajani noted that patients travel from up to
four hours away to receive cancer treatment in Temple. “We do have a very
large patient population here that can benefit from it,” he says.
for Roselie Michelle Davis, from
Brownwood. “Even though she couldn’t
have surgery up front, she became a
surgical candidate after receiving SBRT
treatment,” Dr. Pahlajani says. “She
had an excellent outcome.”
Ms. Davis, age 54, was diagnosed
with pancreatic cancer in early 2016
after receiving an MRI at Baylor Scott &
White Medical Center - Round Rock.
She was referred to Matthew Bower,
MD, a surgical oncologist at Scott &
White Medical Center in Temple, who
outlined her treatment plan.
She went through five months of
chemotherapy before meeting with
Dr. Pahlajani in July to begin SBRT
treatment. “He always explained
everything to me and made sure I
understood what was happening,” Ms.
Davis says. She received five doses of
radiation over five consecutive days,
which Dr. Pahlajani says is standard,
and felt no side effects. Dr. Brower
then performed surgery in September
to remove the tumor. Five months
later, Ms. Davis reported continuing
improvement. “I’m feeling good,” she
says. “I’m getting my strength back.”
Dr. Pahlajani says SBRT can also
be performed on patients who are not
surgical candidates even after the tumor
is reduced. “By using this technique
on tumors that cannot be operated
on, we help these patients as well
by extending their life expectancy,”
he says. He reports that one of his
patients who received a combination
of chemotherapy and SBRT has had
“as good an outcome as if she had
undergone surgery.”
Patients receiving SBRT treatment
must hold perfectly still for Dr.
Pahlajani to target the tumor inside
the pancreas. Patients are placed in a
special, form-fitting couch that can be
rotated to keep the body in the precise
position required. Ms. Davis recalled,
“Every time I went to a radiation
treatment, my body was in the exact
same position.” Each treatment lasts
about 15 minutes.
Dr. Pahlajani must also allow for
a patient’s breathing. “We account for
tumor motion during respiration,” he
says, “so we can hit the tumor no matter
where it is in the respiratory cycle.”
Dr. Pahlajani’s expertise is being
leveraged across the Baylor Scott &
White Health system, as he trains
colleagues at other locations. SBRT is
now available at the Baylor Scott &
White McClinton Cancer Center in
Waco, as well. Dr. Pahlajani and his
team continue to give new hope to
patients with pancreatic cancer. n
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