Failure patterns and outcomes of dose escalation of stereotactic body radiotherapy for locally advanced pancreatic cancer: a multicenter cohort study
| Autor: | Fei Cao, Huojun Zhang, Xixu Zhu, Yusheng Ye, Xianzhi Zhao, Xiaofei Zhu, Shuiwang Qing, Yangsen Cao, Tingshi Su, Xiaoping Ju, Lingong Jiang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
medicine.medical_specialty business.industry medicine.medical_treatment pancreatic cancer Locally advanced lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease lcsh:RC254-282 Effective dose (radiation) Locally advanced pancreatic cancer patterns of failure Radiation therapy Internal medicine Pancreatic cancer dose escalation outcome medicine Dose escalation business Stereotactic body radiotherapy radiotherapy Original Research Cohort study |
| Zdroj: | Therapeutic Advances in Medical Oncology Therapeutic Advances in Medical Oncology, Vol 12 (2020) |
| ISSN: | 1758-8359 |
| DOI: | 10.1177/1758835920977155 |
| Popis: | Objective: This study aims to compare recurrence patterns and outcomes of biologically effective dose (BED10, α/β = 10) of 60–70 Gy with those of a BED10 >70 Gy for locally advanced pancreatic cancer (LAPC). Methods: Patients from three centers with a biopsy and a radiographically proven LAPC were retrospectively included and data were prospectively collected from June 2012 to June 2019. Radiotherapy was delivered by stereotactic body radiation therapy. Recurrences were categorized as in-field, marginal, and outside-the-field recurrence. Patients in two groups were required to receive abdominal enhanced contrast CT or MRI every 2–3 months and CA19-9 examinations every month during follow-up. Treatment-related toxicities were evaluated every month. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Results: After propensity score matching, there were 486 patients in each group. The median prescription dose of the two groups was 37 Gy/5–8 f (range: 36–40.8 Gy/5–8 f) and 42 Gy/5–8 f (range: 40–49.6 Gy/5–8 f), respectively. The median OS of patients with a BED10 >70 Gy and a BED10 60–70 Gy was 20.3 months (95% CI: 19.1–21.5 months) and 18.2 months (95% CI: 17.8–18.6 months) respectively ( p 10 of 60–70 Gy (in-field: 97/486 versus 72/486, p = 0.034; marginal: 109/486 versus 84/486, p = 0.044). However, more patients with BED10 >70 Gy had grade 2 or 3 acute (87/486 versus 64/486, p = 0.042) and late gastrointestinal toxicities (77/486 versus 55/486, p = 0.039) than those with BED10 of 60–70 Gy. Conclusion: BED10 >70 Gy was found to have the best survival benefits along with a higher incidence of acute and late gastrointestinal toxicities. Therefore, a higher dose may be required in the case of patients’ good tolerance. |
| Databáze: | OpenAIRE |
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