Can Stereotactic Body Radiation Therapy Be a Viable and Efficient Therapeutic Option for Unresectable Locally Advanced Pancreatic Adenocarcinoma? Results of a Phase 2 Study

被引:78
作者
Comito, Tiziana [1 ]
Cozzi, L. [1 ]
Clerici, E. [1 ]
Franzese, C. [1 ]
Tozzi, A. [1 ]
Iftode, C. [1 ]
Navarria, P. [1 ]
D'Agostino, G. [1 ]
Rimassa, L. [2 ]
Carnaghi, C. [2 ]
Personeni, N. [2 ]
Tronconi, M. C. [2 ]
De Rose, F. [1 ]
Franceschini, D. [1 ]
Ascolese, A. M. [1 ]
Fogliata, A. [1 ]
Tomatis, S. [1 ]
Santoro, A. [2 ]
Zerbi, A. [3 ]
Scorsetti, M. [1 ]
机构
[1] Ist Clin Humanitas, Radiotherapy, Milan, Italy
[2] Ist Clin Humanitas, Oncol & Hematol, Milan, Italy
[3] Ist Clin Humanitas, Pancreat Surg, Milan, Italy
关键词
pancreas cancer; SBRT; RapidArc; phase II trial; CANCER; RADIOTHERAPY; GEMCITABINE; TRIAL; RADIOSURGERY; CHEMORADIOTHERAPY; CHEMOTHERAPY; SBRT;
D O I
10.1177/1533034616650778
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To assess the efficacy of stereotactic body radiotherapy in patients with unresectable locally advanced pancreatic cancer. Materials and Methods: All patients received a prescription dose of 45 Gy in 6 fractions. Primary end point was freedom from local progression. Secondary end points were overall survival, progression-free survival, and toxicity. Actuarial survival analysis and univariate or multivariate analysis were investigated. Results: Forty-five patients were enrolled in a phase 2 trial. Median follow-up was 13.5 months. Freedom from local progression was 90% at 2 years. On univariate (P < .03) and multivariate analyses (P < .001), lesion size was statistically significant for freedom from local progression. Median progression-free survival and overall survival were 8 and 13 months, respectively. On multivariate analysis, tumor size (P < .001) and freedom from local progression (P < .002) were significantly correlated with overall survival. Thirty-two (71%) patients with locally advanced pancreatic cancer received chemotherapy before stereotactic body radiotherapy. Median overall survival from diagnosis was 19 months. Multivariate analysis showed that freedom from local progression (P < .035), tumor diameter (P < .002), and computed tomography before stereotactic body radiotherapy (P < .001) were significantly correlated with overall survival from diagnosis. Conclusion: Stereotactic body radiotherapy is a safe and effective treatment for patients with locally advanced pancreatic cancer with no G3 toxicity or greater and could be a promising therapeutic option in multimodality treatment regimen.
引用
收藏
页码:295 / 301
页数:7
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