Literature DB >> 31015127

Concurrent chemoradiotherapy using proton beams for unresectable locally advanced pancreatic cancer.

Yuichi Hiroshima1, Nobuyoshi Fukumitsu2, Takashi Saito2, Haruko Numajiri2, Keiko Nemoto Murofushi2, Kayoko Ohnishi2, Tetsuo Nonaka2, Hitoshi Ishikawa2, Toshiyuki Okumura2, Hideyuki Sakurai2.   

Abstract

BACKGROUND AND
PURPOSE: We investigated clinical outcomes of proton beam concurrent chemoradiotherapy (CCRT) for unresectable, locally advanced pancreatic cancer (LAPC) patients.
MATERIALS AND METHODS: Records from 42 unresectable LAPC patients (21 male and 21 female, 39-83 years old) with IIB/III clinical staging of 1/41 treated by proton beam CCRT were retrospectively reviewed. Twelve patients received a conventional 50 Gray equivalents (GyE) in 25 fractions protocol and 30 others received a higher dose protocol of 54.0-67.5 GyE in 25-33 fractions. Gemcitabine or S-1 (Tegafur, Gimeracil and Oteracil) was used concurrently. Toxicity, overall survival (OS) and local control (LC) were examined.
RESULTS: Acute adverse events of grades 1, 2, 3 and 4 were found in 4, 15, 17 and 2 patients, respectively. All grade 3 and 4 events were hematologic. Late adverse events of grades 1 and 2 were found in 3 and 2 patients, respectively. No late adverse effects of grade 3 or higher were observed. The 1-year/2-year OS rates from the start of CCRT were 77.8/50.8% with median survival time (MST) of 25.6 months. The 1-year/2-year LC rate from CCRT start was 83.3/78.9% with a median time to local recurrence of more than 36 months. Total irradiation dose was the only significant factor in univariate analyses of OS and LC (p = 0.015 and 0.023, respectively).
CONCLUSION: Proton beam CCRT lengthened survival periods compared to previous photon CCRT data and higher dose irradiation prolonged LC and OS for unresectable LAPC patients. Proton beam therapy is therefore safe and effective in these cases.
Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Chemotherapy; Pancreatic cancer; Proton beam therapy; Radiotherapy

Mesh:

Year:  2019        PMID: 31015127     DOI: 10.1016/j.radonc.2019.03.012

Source DB:  PubMed          Journal:  Radiother Oncol        ISSN: 0167-8140            Impact factor:   6.280


  17 in total

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