Stereotactic Body Radiotherapy as an Effective Treatment for Pancreatic Cancer.

Autor:	Hurmuz P; Radiation Oncology, Hacettepe University Medical School, Ankara, TUR., Cengiz M; Radiation Oncology, Hacettepe University Medical School, Ankara, TUR., Ozyigit G; Radiation Oncology, Hacettepe University Medical School, Ankara, TUR., Yuce Sari S; Radiation Oncology, Hacettepe University Medical School, Ankara, TUR., Kahvecioglu A; Radiation Oncology, Hacettepe University Medical School, Ankara, TUR., Beduk Esen CS; Radiation Oncology, Hacettepe University Medical School, Ankara, TUR., Yalcin S; Medical Oncology, Hacettepe University Medical School, Ankara, TUR., Zorlu F; Radiation Oncology, Hacettepe University Medical School, Ankara, TUR.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Apr 28; Vol. 15 (4), pp. e38255. Date of Electronic Publication: 2023 Apr 28 (Print Publication: 2023).
DOI:	10.7759/cureus.38255
Abstrakt:	Background Stereotactic body radiotherapy (SBRT) allows the delivery of an ablative radiation dose to the tumor with minimal toxicity. Although magnetic resonance imaging (MRI)-guided SBRT appears to be a promising approach in the modern era, X-ray image-guided SBRT is still used worldwide for pancreatic cancer. This study aims to evaluate the results of X-ray image-guided SBRT in patients with locally advanced pancreatic cancer (LAPC). Methodology Medical records of 24 patients with unresectable LAPC who underwent X-ray image-guided SBRT between 2009 and 2022 were retrospectively evaluated. SPSS version 23.0 (IBM Corp., Armonk, NY, USA) was utilized for all analyses. Results The median age was 64 years (range = 42-81 years), and the median tumor size was 3.5 cm (range = 2.7-4 cm). The median total dose of SBRT was 35 Gy (range = 33-50 Gy) in five fractions. After SBRT, 30% of patients showed complete and 41% showed partial response, whereas 20% had stable disease and 9% had progression. Median follow-up was 15 months (range = 6-58 months). During follow-up, four (16%) patients had local recurrence, one (4%) had a regional recurrence, and 17 (70%) had distant metastasis (DM). The two-year local control (LC), local recurrence-free survival (LRFS), overall survival (OS), and DM-free survival (DMFS) rate was 87%, 36%, 37%, and 29%, respectively. In univariate analysis, a larger tumor size (>3.5 cm) and higher cancer antigen 19-9 level (>106.5 kU/L) significantly decreased the OS, LRFS, and DMFS rates. No severe acute toxicity was observed. However, two patients had severe late toxicity as intestinal bleeding. Conclusions X-ray image-guided SBRT provides a good LC rate with minimal toxicity for unresectable LAPC. However, despite modern systemic treatments, the rate of DM remains high which plays a major role in survival. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Hurmuz et al.)
Databáze:	MEDLINE
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