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The Role of Stereotactic Body Radiation Therapy for Pancreatic Cancer: A Single-Institution Experience
- Source :
- Annals of Surgical Oncology. 22:2352-2358
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- Stereotactic body radiation therapy (SBRT) is a promising option for patients with pancreatic cancer (PCA); however, limited data support its efficacy. This study reviews our institutional experience of SBRT in the treatment of locally advanced (LAPC) and borderline resectable (BRPC) PCA. Charts of all PCA patients receiving SBRT at our institution from 2010 to 2014 were reviewed. Most patients received pre-SBRT chemotherapy. Primary endpoints included overall survival (OS) and local progression-free survival (LPFS). Patients received a total dose of 25–33 Gy in five fractions. A total of 88 patients were included in the analysis, 74 with LAPC and 14 with BRPC. The median age at diagnosis was 67.2 years, and median follow-up from date of diagnosis for LAPC and BRPC patients was 14.5 and 10.3 months, respectively. Median OS from date of diagnosis was 18.4 months (LAPC, 18.4 mo; BRPC, 14.4 mo) and median PFS was 9.8 months (95 % CI 8.0–12.3). Acute toxicity was minimal with only three patients (3.4 %) experiencing acute grade ≥3 toxicity. Late grade ≥2 gastrointestinal toxicity was seen in five patients (5.7 %). Of the 19 patients (21.6 %) who underwent surgery, 79 % were LAPC patients and 84 % had margin-negative resections. Chemotherapy followed by SBRT in patients with LAPC and BRPC resulted in minimal acute and late toxicity. A large proportion of patients underwent surgical resection despite limited radiographic response to therapy. Further refinements in the integration of chemotherapy, SBRT, and surgery might offer additional advancements toward optimizing patient outcomes.
- Subjects :
- Adult
Male
Oncology
medicine.medical_specialty
medicine.medical_treatment
Adenocarcinoma
Radiosurgery
urologic and male genital diseases
Article
Surgical oncology
Pancreatic cancer
Internal medicine
medicine
Humans
Prospective Studies
Prospective cohort study
Survival rate
Aged
Neoplasm Staging
Retrospective Studies
Aged, 80 and over
Chemotherapy
business.industry
Dose fractionation
Retrospective cohort study
Middle Aged
Prognosis
medicine.disease
Pancreatic Neoplasms
Survival Rate
Clinical trial
Female
Surgery
Dose Fractionation, Radiation
Radiology
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15344681 and 10689265
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....2ff2d0d30810c4f59b4d950d61e55f42