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- Title
SBRT in unresectable advanced pancreatic cancer: preliminary results of a mono-institutional experience.
- Authors
Tozzi, Angelo; Comito, Tiziana; Alongi, Filippo; Navarria, Pierina; Iftode, Cristina; Mancosu, Pietro; Reggiori, Giacomo; Clerici, Elena; Rimassa, Lorenza; Zerbi, Alessandro; Fogliata, Antonella; Cozzi, Luca; Tomatis, Stefano; Scorsetti, Marta
- Abstract
Background: To assess the efficacy and safety of stereotactic body radiotherapy (SBRT) in patients with either unresectable locally advanced pancreatic adenocarcinoma or by locally recurrent disease after surgery. Methods: Between January 2010 and October 2011, 30 patients with unresectable or recurrent pancreatic adenocarcinoma underwent exclusive SBRT. Twenty-one patients (70%) presented with unresectable locallyadvanced disease and 9 patients (30%) showed local recurrence after surgery. No patients had metastatic disease. Gemcitabine-based chemotherapy was administered to all patients before SBRT. Prescription dose was 45Gy in 6 daily fractions of 7.5Gy. SBRT was delivered using the volumetric modulated arc therapy (VMAT) by RapidArc. Primary end-point of this study was freedom from local progression (FFLP), secondary end-points were overall survival (OS), progression free survival (PFS) and toxicity. Results: Median Clinical Target Volume (CTV) was 25.6 cm3 (3.2-78.8 cm3) and median Planning Target Volume (PTV) was 70.9 cm3 (20.4- 205.2 cm3). The prescription dose was delivered in 25 patients (83%), in 5 patients (17%) it was reduced to 36Gy in 6 fractions not to exceed the dose constraints of organs at risk (OARs). Median follow-up was 11 months (2-28 months). FFLP was 91% at 6 months, 85% at median follow-up and 77% at 1 and 2 years. For the group with prescription dose of 45Gy, FFLP was 96% at 1 and 2 years. The median PFS was 8 months. The OS was 47% at 1 year and median OS was 11 months. At the end of the follow-up, 9 patients (32%) were alive and 4 (14%) were free from progression. No patients experienced G ≥ 3 acute toxicity. Conclusions: Our preliminary results show that SBRT can obtain a satisfactory local control rate for unresectable locally advanced and recurrent pancreatic adenocarcinoma. This fractionation schedule is feasible, and no G ≥i 3 toxicity was observed. SBRT is an effective emerging technique in the multi-modality treatment of locally advancedpancreatic tumors.
- Subjects
PANCREATIC cancer treatment; ADENOCARCINOMA; CANCER relapse; CANCER chemotherapy; TOXICITY testing
- Publication
Radiation Oncology, 2013, Vol 8, Issue 1, p1
- ISSN
1748-717X
- Publication type
Article
- DOI
10.1186/1748-717X-8-148