Stereotactic body radiotherapy in the treatment of advanced adenocarcinoma of the pancreas
American Journal of Clinical Oncology, 02/03/2011
Rwigema JC et al.
– SBRT is feasible, with minimal grade ≥3 toxicity. The overall FFLP rate for all patients was 64.8%, comparable to rates with external beam radiotherapy. This shorter treatment course can be delivered without delay in adjuvant systemic therapy.
Reviewed outcomes of 71 patients treated with SBRT for pancreatic cancer between July 2004 and January 2009
40 patients (56%) had locally unresectable disease, 11 patients (16%) had local recurrence following surgical resection, 8 patients (11%) had metastatic disease, and 12 patients (17%) received adjuvant SBRT for positive margins
Median dose 24 Gy (18–25 Gy), given in single-fraction SBRT (n = 67) or fractionated SBRT (n = 4)
Kaplan-Meyer survival analyses used to estimate freedom from local progression (FFLP) and OS rates
Median follow-up among surviving patients was 12.7 months (4–26 months)
The median tumor volume was 17 mL (5.1–249 mL)
Overall FFLP rates at 6 months/1 year 71.7%/48.5%
Among those with macroscopic disease, FFLP achieved in 77.3% of patients with tumor size <15 mL (n = 22), and 59.5% for ≥15 mL (n = 37) (P = 0.02)
FFLP achieved in 73% following 24 to 25 Gy, and 45% with 18 to 22 Gy (P = 0.004)
Median OS 10.3 months, with 6 month/1 year OS rates of 65.3%/41%, respectively
Grade 1–2 acute and late GI toxicity seen in 39.5% of patients
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