OBJECTIVES: The aim of the study was to assess the feasibility and safety of stereotactic body radiotherapy (SBRT) in patients with advanced pancreatic adenocarcinoma. METHODS: We reviewed outcomes of 71 patients treated with SBRT for pancreatic cancer between July 2004 and January 2009. Forty patients (56%) had locally unresectable disease, 11 patients (16%) had local recurrence following surgical resection, 8 patients (11%) had metastatic disease, and 12 patients (17%) received adjuvant SBRT for positive margins. The median dose was 24 Gy (18-25 Gy), given in a single-fraction SBRT (n = 67) or fractionated SBRT (n = 4). Kaplan-Meyer survival analyses were used to estimate freedom from local progression (FFLP) and overall survival (OS) rates. RESULTS: The median follow-up among surviving patients was 12.7 months (4-26 months). The median tumor volume was 17 mL (5.1-249 mL). The overall FFLP rates at 6 months/1 year were 71.7%/48.5%, respectively. Among those with macroscopic disease, FFLP was achieved in 77.3% of patients with tumor size <15 mL (n = 22), and 59.5% for ≥15 mL (n = 37) (P = 0.02). FFLP was achieved in 73% following 24 to 25 Gy, and 45% with 18 to 22 Gy (P = 0.004). The median OS was 10.3 months, with 6 month/1 year OS rates of 65.3%/41%, respectively. Grade 1-2 acute and late GI toxicity were seen in 39.5% of patients. Three patients experienced acute grade 3 toxicities. CONCLUSIONS: SBRT is feasible, with minimal grade ≥3 toxicity. The overall FFLP rate for all patients was 64.8%, comparable to rates with external beam radiotherapy. This shorter treatment course can be delivered without delay in adjuvant systemic therapy.
OBJECTIVES: The aim of the study was to assess the feasibility and safety of stereotactic body radiotherapy (SBRT) in patients with advanced pancreatic adenocarcinoma. METHODS: We reviewed outcomes of 71 patients treated with SBRT for pancreatic cancer between July 2004 and January 2009. Forty patients (56%) had locally unresectable disease, 11 patients (16%) had local recurrence following surgical resection, 8 patients (11%) had metastatic disease, and 12 patients (17%) received adjuvant SBRT for positive margins. The median dose was 24 Gy (18-25 Gy), given in a single-fraction SBRT (n = 67) or fractionated SBRT (n = 4). Kaplan-Meyer survival analyses were used to estimate freedom from local progression (FFLP) and overall survival (OS) rates. RESULTS: The median follow-up among surviving patients was 12.7 months (4-26 months). The median tumor volume was 17 mL (5.1-249 mL). The overall FFLP rates at 6 months/1 year were 71.7%/48.5%, respectively. Among those with macroscopic disease, FFLP was achieved in 77.3% of patients with tumor size <15 mL (n = 22), and 59.5% for ≥15 mL (n = 37) (P = 0.02). FFLP was achieved in 73% following 24 to 25 Gy, and 45% with 18 to 22 Gy (P = 0.004). The median OS was 10.3 months, with 6 month/1 year OS rates of 65.3%/41%, respectively. Grade 1-2 acute and late GI toxicity were seen in 39.5% of patients. Three patients experienced acute grade 3 toxicities. CONCLUSIONS: SBRT is feasible, with minimal grade ≥3 toxicity. The overall FFLP rate for all patients was 64.8%, comparable to rates with external beam radiotherapy. This shorter treatment course can be delivered without delay in adjuvant systemic therapy.
Authors: Kush Goyal; Douglas Einstein; Rafael A Ibarra; Min Yao; Charles Kunos; Rod Ellis; James Brindle; Deepjot Singh; Jeffrey Hardacre; Yuxia Zhang; Jeffrey Fabians; Gary Funkhouser; Mitchell Machtay; Juan R Sanabria Journal: J Surg Res Date: 2011-09-05 Impact factor: 2.192
Authors: Shalini Moningi; Avani S Dholakia; Siva P Raman; Amanda Blackford; John L Cameron; Dung T Le; Ana M C De Jesus-Acosta; Amy Hacker-Prietz; Lauren M Rosati; Ryan K Assadi; Shirl Dipasquale; Timothy M Pawlik; Lei Zheng; Matthew J Weiss; Daniel A Laheru; Christopher L Wolfgang; Joseph M Herman Journal: Ann Surg Oncol Date: 2015-01-07 Impact factor: 5.344
Authors: E Gkika; S Adebahr; S Kirste; T Schimek-Jasch; R Wiehle; R Claus; U Wittel; U Nestle; D Baltas; A L Grosu; T B Brunner Journal: Strahlenther Onkol Date: 2017-01-30 Impact factor: 3.621
Authors: Aaron T Wild; Susan M Hiniker; Daniel T Chang; Phuoc T Tran; Mouen A Khashab; Maneesha R Limaye; Daniel A Laheru; Dung T Le; Rachit Kumar; Jonathan S Pai; Blaire Hargens; Andrew B Sharabi; Eun Ji Shin; Lei Zheng; Timothy M Pawlik; Christopher L Wolfgang; Albert C Koong; Joseph M Herman Journal: J Gastrointest Oncol Date: 2013-12