Thomas B Brunner1, Ursula Nestle2, Anca-Ligia Grosu2, Mike Partridge3. 1. Department of Radiation Oncology, University Hospitals Freiburg, Germany. Electronic address: Thomas.brunner@uniklinik-freiburg.de. 2. Department of Radiation Oncology, University Hospitals Freiburg, Germany. 3. CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, UK.
Abstract
PURPOSE/ OBJECTIVE: To analyse outcome and toxicity of stereotactic body radiotherapy (SBRT) in pancreatic cancer (PDAC). MATERIAL/ METHODS: We systematically reviewed full reports on outcome and toxicity transforming prescription doses to equivalent doses of 2 Gy (EQD2) and biological equivalent doses (BED). Pearson product-moment correlation coefficient, regression analysis and Lyman-Kutcher-Burman modelling were used. RESULTS: Sixteen trials (572 patients) were identified. Local control correlated with dose. Additionally 4 upper gastrointestinal-SBRT trials (149 patients) were included for toxicity analysis. Acute toxicity was mild but late toxicity ⩾G2 was substantial and predominantly gastrointestinal. Late toxicity ⩾G2 and ⩾G3 correlated highly with EQD2/BED after linear (R(2)=0.85 and 0.77, respectively) and Lyman-Kutcher-Burman modelling. Linear regression lines indicated ⩾G2 and ⩾G3 toxicity frequencies of 5% at 65 Gy and 80 Gy EQD2-α/β=3, respectively. A comparison of toxicity with dose constraints for duodenum revealed partly inadequate dose constraints. CONCLUSION: RESULTS from multiple fraction regimens could be successfully interpreted to estimate toxicity according to EQD2/BED prescription doses, and dose constraints for the duodenum were derived, whereas local control appeared to be less dose-dependent. This analysis may be useful to plan clinical trials for SBRT and hypofractionated radiotherapy in pancreatic cancer.
PURPOSE/ OBJECTIVE: To analyse outcome and toxicity of stereotactic body radiotherapy (SBRT) in pancreatic cancer (PDAC). MATERIAL/ METHODS: We systematically reviewed full reports on outcome and toxicity transforming prescription doses to equivalent doses of 2 Gy (EQD2) and biological equivalent doses (BED). Pearson product-moment correlation coefficient, regression analysis and Lyman-Kutcher-Burman modelling were used. RESULTS: Sixteen trials (572 patients) were identified. Local control correlated with dose. Additionally 4 upper gastrointestinal-SBRT trials (149 patients) were included for toxicity analysis. Acute toxicity was mild but late toxicity ⩾G2 was substantial and predominantly gastrointestinal. Late toxicity ⩾G2 and ⩾G3 correlated highly with EQD2/BED after linear (R(2)=0.85 and 0.77, respectively) and Lyman-Kutcher-Burman modelling. Linear regression lines indicated ⩾G2 and ⩾G3 toxicity frequencies of 5% at 65 Gy and 80 Gy EQD2-α/β=3, respectively. A comparison of toxicity with dose constraints for duodenum revealed partly inadequate dose constraints. CONCLUSION: RESULTS from multiple fraction regimens could be successfully interpreted to estimate toxicity according to EQD2/BED prescription doses, and dose constraints for the duodenum were derived, whereas local control appeared to be less dose-dependent. This analysis may be useful to plan clinical trials for SBRT and hypofractionated radiotherapy in pancreatic cancer.
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: Tiziana Comito; L Cozzi; E Clerici; C Franzese; A Tozzi; C Iftode; P Navarria; G D'Agostino; L Rimassa; C Carnaghi; N Personeni; M C Tronconi; F De Rose; D Franceschini; A M Ascolese; A Fogliata; S Tomatis; A Santoro; A Zerbi; M Scorsetti Journal: Technol Cancer Res Treat Date: 2016-06-16