Alleviating retroperitoneal pain with celiac plexus radiosurgery

• Published in: The lancet oncology Vol. 25; no. 8; pp. 952 - 953
• Main Authors: Moore-Palhares, Daniel, Ng, Sylvia S W, Louie, Alexander V
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2024; Elsevier Limited
• Subjects: Abdomen; Abdominal Pain - etiology; Cancer therapies; Celiac Plexus; Chemotherapy; Drug dosages; Drug therapy; Humans; Pain; Pancreatic cancer; Patients; Radiation therapy; Radiosurgery; Radiosurgery - adverse effects; Retroperitoneal Space; Toxicity; Treatment Outcome
• ISSN: 1470-2045; 1474-5488; 1474-5488
• DOI: 10.1016/S1470-2045(24)00285-7

Additionally, although radiosurgery is convenient, some radiation oncologists might be reluctant to prescribe 25 Gy because high-dose single-fraction treatment is uncommon for abdominal tumours.8 Furthermore, the celiac plexus' proximity to luminal organs might raise concerns about late toxicity, particularly when radiosurgery is administered between chemotherapy cycles.8,9 Regardless, use of celiac plexus radiosurgery is expected to increase as radiation oncologists gain clinical experience and growing evidence supports its adoption. Improved radiation precision through integration of adaptive radiotherapy and diagnostic-quality imaging into radiation treatment units might increase confidence in this approach. 10 Finally, what are the late toxicity risks from radiosurgery, and are these even accurately measurable given the poor survival of this patient population and challenges with differentiating treatment-related toxicity from tumour progression?