In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 32, No. 3_suppl ( 2014-01-20), p. 317-317
Abstract:
317 Background: To report updated outcomes and toxicity of stereotactic body radiotherapy (SBRT) for patients with unresectable pancreatic adenocarcinoma treated over the past 11 years from a single institution. Methods: One hundred and ninety-nine patients with primary, unresectable pancreatic adenocarcinoma were treated with SBRT at our institution from 2002 to 2013. One hundred and sixty-four had locally advanced disease, 12 had borderline resectable disease, 21 were medically inoperable, and 2 had resectable disease but refused surgery. Fifteen patients had metastases at the time of SBRT. Forty-six patients were treated with prior RT, 16 of whom were enrolled on a combined IMRT/SBRT trial. Most common treatment regimens were 25 Gy x 1 (51.3%), 6.6 Gy x 5 (25.6%), 6 Gy x 5 (15.0%). Fifty-seven patients had no prior/current chemo while 142 patients had prior/current chemo (134 had gemcitabine-based chemo). BED 10 and BED 3 were defined using the linear quadratic equation assuming an α/β of 10 and 3, respectively. Results: Median follow-up was 7.1 months (0.13-63.58). The 6- and 12-month cumulative incidence of local recurrence (CIR) were 7.93% (4.07-11.80%, 95% CI) and 12.48% (7.68-17.28%, 95% CI), respectively. Three patients converted to resection after SBRT. BED 10 (median 87.5, range 19.5-97.5), prior RT, prior/current chemo, and tumor location did not predict for CIR. OS rates at 6 months and 12 months were 71.23% (65.02-78.0%, 95% CI) and 36.23% (29.54-44.4%, 95% CI), respectively. Median OS from date of diagnosis was 14.27 months (13.25-16.90 95% CI). Patients who received prior/current chemo had better OS (p=0.0035). There were 26 (13%) recorded GI ulcers/strictures/bleed (5 acute, 21 late) after treatment. BED 3 (median 233.3, 30-233.3) predicted for these toxicities (OR 1.01, 1.00-1.01 95% CI, p=0.022), while age, prior RT, prior/current chemo, tumor location did not. Conclusions: SBRT for pancreatic adenocarcinoma is effective for local control with associated risk of toxicity. The risk of GI toxicity is correlated with BED 3 . Survival is associated with the use of chemotherapy. SBRT may be advantageous due to its good local control with shortened treatment duration that minimizes interruption in chemotherapy.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2014.32.3_suppl.317
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2014
detail.hit.zdb_id:
2005181-5
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