The Role of Stereotactic Body Radiation Therapy for Pancreatic Cancer: A Single-Institution Experience
Autor: | Shirl Dipasquale, Matthew J. Weiss, Amanda L. Blackford, Ana De Jesus-Acosta, Daniel A. Laheru, Amy Hacker-Prietz, Siva P. Raman, Lauren M. Rosati, Joseph M. Herman, Shalini Moningi, Avani S. Dholakia, Dung T. Le, Christopher L. Wolfgang, John L. Cameron, Lei Zheng, Ryan Assadi, Timothy M. Pawlik |
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Rok vydání: | 2015 |
Předmět: |
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 |
Zdroj: | Annals of Surgical Oncology. 22:2352-2358 |
ISSN: | 1534-4681 1068-9265 |
Popis: | 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. |
Databáze: | OpenAIRE |
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