Stereotactic Body Radiation Therapy plus Induction Chemotherapy versus Stereotactic Body Radiation Therapy plus Adjuvant Chemotherapy for Early Stage but Medically Inoperable Pancreatic Cancer: A Propensity Score Matched Analysis

2018 ◽  
Vol 102 (3) ◽  
pp. e83
Author(s):  
X. Zhu ◽  
F. Li ◽  
W. Liu ◽  
D. Shi ◽  
X. Ju ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Induction Chemotherapy ◽  
Stereotactic Body Radiation Therapy ◽  
Early Stage ◽  
Stereotactic Body Radiation

Association of survival with stereotactic body radiation therapy following induction chemotherapy for unresected locally advanced pancreatic cancer

2021 ◽  
pp. 1-8
Author(s):  
Sung Jun Ma ◽  
Lucas M. Serra ◽  
Austin J. Bartl ◽  
Hye Ri Han ◽  
Fatemeh Fekrmandi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Induction Chemotherapy ◽  
Survival Benefit ◽  
Stereotactic Body Radiation Therapy ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Cox Proportional Hazards ◽  
Locally Advanced Pancreatic Cancer ◽  
Stereotactic Body Radiation

Abstract Aim: Induction chemotherapy (iC) followed by concurrent chemoradiation has been shown to improve overall survival (OS) for locally advanced pancreatic cancer (LAPC). However, the survival benefit of stereotactic body radiation therapy (SBRT) versus conventionally fractionated radiation therapy (CFRT) following iC remains unclear. Materials and methods: The National Cancer Database (NCDB) was queried for primary stage III, cT4N0-1M0 LAPC (2004–15). Kaplan–Meier analysis, Cox proportional hazards method and propensity score matching were used. Results: Among 872 patients, 738 patients underwent CFRT and 134 patients received SBRT. Median follow-up was 24·3 and 22·9 months for the CFRT and SBRT cohorts, respectively. The use of SBRT showed improved survival in both the multivariate analysis (hazards ratio 0·78, p = 0·025) and 120 propensity-matched pairs (median OS 18·1 versus 15·9 months, p = 0·004) compared to the CFRT. Findings: This NCDB analysis suggests survival benefit with the use of SBRT versus CFRT following iC for the LAPC.

Neoadjuvant stereotactic body radiation therapy (SBRT) for borderline resectable pancreas cancer: Moffitt Cancer Center initial experience.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 302-302
Author(s):  
M. D. Chuong ◽  
R. Shridhar ◽  
M. Patel ◽  
J. Klapman ◽  
J. S. Barthel ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Induction Chemotherapy ◽  
Stereotactic Body Radiation Therapy ◽  
Pancreas Cancer ◽  
Cancer Center ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Borderline Resectable Pancreatic Cancer ◽  
Stereotactic Body Radiation

302 Background: Our institution has reported a strategy of using neoadjuvant GTX (gemcitabine, docetaxel, and capecitabine) chemotherapy followed by 5FU-based intensity-modulated radiation therapy (IMRT) for borderline resectable pancreas cancer. We now report our early experience with induction chemotherapy followed by stereotactic body radiation therapy (SBRT). Methods: This retrospective review evaluates our initial 5 fraction SBRT experience in 15 patients following induction chemotherapy for borderline resectable pancreatic cancer. Staging included pancreatic protocol CT, endoscopic ultrasound, and PET/CT scan. Induction regimens consisted of GTX for 3 cycles in 12 patients and gemcitabine alone in 3. Daily SBRT was delivered to the pancreas at least 1 week after completing systemic chemotherapy. Endoscopically implanted fiducial markers and daily cone beam CT were used for image guidance. Treatment was delivered on a Varian Trilogy unit using 6-15 MV photons. Doses were selected based on dose painting the portion of tumor adjacent to the vasculature to a higher dose while meeting normal tissue constraints. The entire gross tumor received a dose of 5-6 Gy per fraction while the portion of the tumor adjacent to the vasculature resulting in the borderline designation received up to 8 Gy per fraction. Patients were re-imaged 3-4 weeks after SBRT for consideration of surgery. Results: There were no acute or late grade 3 toxicities. At the time of this analysis, not all treated patients have reached the restaging time point, but 9 of 15 (60%) were candidates for resection. Six patients have gone to resection with negative margins and without any increased complications. Two patients were found to have disease surrounding the vasculature preventing resection. One patient had cardiac issues at surgery and resection was aborted. One patient was explored and found to have liver metastases. Conclusions: Integration of SBRT in conjunction with systemic therapy is well-tolerated and appears to facilitate margin-negative resection in borderline resectable pancreatic cancer. No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document