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

医学 放射治疗 胰腺癌 多元分析 放射外科 临床终点 单变量分析 无进展生存期 养生 肿瘤进展 内科学 癌症 肿瘤科 外科 放射科 化疗 随机对照试验
作者
Tiziana Comito,Luca Cozzi,Elena Clerici,Ciro Franzese,A. Tozzi,C. Iftode,Pierina Navarria,Giuseppe Roberto D’Agostino,Lorenza Rimassa,Carlo Carnaghi,Nicola Personeni,Maria Chiara Tronconi,Fiorenza De Rose,Davide Franceschini,A.M. Ascolese,Antonella Fogliata,Stefano Tomatis,Armando Santoro,Alessandro Zerbi,Marta Scorsetti
出处
期刊:Technology in Cancer Research & Treatment [SAGE Publishing]
卷期号:16 (3): 295-301 被引量:82
标识
DOI:10.1177/1533034616650778
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.
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