Clinical results of stereotactic body radiotherapy (SBRT) in the treatment of isolated local recurrence of pancreatic cancer after R0 surgery: A retrospective study

被引：35

作者：

Comito, T. ^{[1
]}

Cozzi, L. ^{[1
]}

Zerbi, A. ^{[3
]}

Franzese, C. ^{[1
]}

Clerici, E. ^{[1
]}

Tozzi, A. ^{[1
]}

Iftode, C. ^{[1
]}

Navarria, P. ^{[1
]}

D'Agostino, G. ^{[1
]}

Fogliata, A. ^{[1
]}

Mancosu, P. ^{[1
]}

Tomatis, S. ^{[1
]}

Carnaghi, C. ^{[2
]}

Personeni, N. ^{[2
]}

Santoro, A. ^{[2
]}

Scorsetti, M. ^{[1
,4
]}

机构：

[1] Ist Clin Humanitas, Radiotherapy & Radiosurg, Rozzano, Italy

[2] Ist Clin Humanitas, Oncol & Hematol, Rozzano, Italy

[3] Ist Clin Humanitas, Pancreat Surg, Rozzano, Italy

[4] Humanitas Univ, Dept Biomed Sci, Rozzano, Italy

来源：

EJSO | 2017年 / 43卷 / 04期

关键词：

Pancreas cancer; SBRT; VMAT; RapidArc; DUCTAL ADENOCARCINOMA; RE-RESECTION; PATTERNS; CHEMORADIATION; CARCINOMA; FAILURE;

D O I：

10.1016/j.ejso.2016.12.012

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective: To evaluate the efficacy and the feasibility of SBRT for selected patients with isolated local recurrence of pancreatic cancer after radical surgery. Methods: A retrospective analysis was performed on patients treated with SBRT for isolated local recurrence from resected pancreatic adenocarcinoma, after multidisciplinary board evaluation. Prescription dose was 45 Gy in 6 fractions for all patients. Primary end-point was freedom from local progression (PIMP). Secondary end-points were overall survival (OS), progression free survival (PFS) and toxicity. Local control was defined according to RECIST criteria. Acute and late toxicity was scored according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Results: Between January 2011 and February 2015, 31 patients with isolated local recurrence of resected pancreatic cancer were treated with SBRT. Pancreato-duodenectomy (PD) was performed on 24 patients and distal pancreatectomy (DP) in 7 cases, all with radical resection (R0). Median local recurrence disease free interval (DFI) was 14 months. Median follow-up was 12 months. FFLP was 91% and 82% at 1 and 2-years, respectively. Median PFS was 9 months. Median OS was 18 months. At univariate analysis, OS was correlated with a DFI > 18 months. No cases of acute G3 toxicity or greater occurred. Conclusions: SBRT seems to be an effective and safe therapeutic option for isolated local recurrence of pancreatic cancer after surgery. Encouraging local control rate, very low toxicity profile and effective pain control suggest the crucial role of SBRT in the treatment of these long-survivors selected patients. (C) 2017 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：735 / 742

页数：8

共 20 条

[1] SBRT in pancreatic cancer: What is the therapeutic window? [J].

Brunner, Thomas B. ;

Nestle, Ursula ;

Grosu, Anca-Ligia ;

Partridge, Mike .

RADIOTHERAPY AND ONCOLOGY, 2015, 114 (01) :109-116

[2]

Crane C, 2011, JCO, V29, P22

[3] New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) [J].

Eisenhauer, E. A. ;

Therasse, P. ;

Bogaerts, J. ;

Schwartz, L. H. ;

Sargent, D. ;

Ford, R. ;

Dancey, J. ;

Arbuck, S. ;

Gwyther, S. ;

Mooney, M. ;

Rubinstein, L. ;

Shankar, L. ;

Dodd, L. ;

Kaplan, R. ;

Lacombe, D. ;

Verweij, J. .

EUROPEAN JOURNAL OF CANCER, 2009, 45 (02) :228-247

[4] Chemoradiation in patients with isolated recurrent pancreatic cancer - therapeutical efficacy and probability of re-resection [J].

Habermehl, Daniel ;

Brecht, Ingo C. ;

Bergmann, Frank ;

Welzel, Thomas ;

Rieken, Stefan ;

Werner, Jens ;

Schirmacher, Peter ;

Buechler, Markus W. ;

Debus, Juergen ;

Combs, Stephanie E. .

RADIATION ONCOLOGY, 2013, 8

[5] Do Recurrent and Metastatic Pancreatic Cancer Patients Have the Same Outcomes with Gemcitabine Treatment? [J].

Hashimoto, Kenji ;

Ueno, Hideki ;

Ikeda, Masafumi ;

Kojima, Yasushi ;

Hagihara, Atsushi ;

Kondo, Shunsuke ;

Morizane, Chigusa ;

Okusaka, Takuji .

ONCOLOGY, 2009, 77 (3-4) :217-223

[6]

Hernandez JM, 2010, AM SURGEON, V76, P480

[7] DPC4 Gene Status of the Primary Carcinoma Correlates With Patterns of Failure in Patients With Pancreatic Cancer [J].

Iacobuzio-Donahue, Christine A. ;

Fu, Baojin ;

Yachida, Shinichi ;

Luo, Mingde ;

Abe, Hisashi ;

Henderson, Clark M. ;

Vilardell, Felip ;

Wang, Zheng ;

Keller, Jesse W. ;

Banerjee, Priya ;

Herman, Joseph M. ;

Cameron, John L. ;

Yeo, Charles J. ;

Halushka, Marc K. ;

Eshleman, James R. ;

Raben, Marian ;

Klein, Alison P. ;

Hruban, Ralph H. ;

Hidalgo, Manuel ;

Laheru, Daniel .

JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (11) :1806-1813

[8]

Kim Yoon Ji, 2008, Korean J Gastroenterol, V51, P181

[9] Surgery for recurrent pancreatic ductal adenocarcinoma [J].

Kleeff, Joerg ;

Reiser, Carolin ;

Hinz, Ulf ;

Bachmann, Jeannine ;

Debus, Jurgen ;

Jaeger, Dirk ;

Friess, Helmut ;

Buechler, Markus W. .

ANNALS OF SURGERY, 2007, 245 (04) :566-572

[10]

Morganti AG, 2003, STRAHLENTHER ONKOL, V179, P87, DOI 10.1007/s00066-003-1043-y

← 1 2 →