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

Technology in cancer research & treatment

PubMedID: 27311310

Comito T, Cozzi L, Clerici E, Franzese C, Tozzi A, Iftode C, Navarria P, D'Agostino G, Rimassa L, Carnaghi C, Personeni N, Tronconi MC, De Rose F, Franceschini D, Ascolese AM, Fogliata A, Tomatis S, Santoro A, Zerbi A, Scorsetti M. Can Stereotactic Body Radiation Therapy Be a Viable and Efficient Therapeutic Option for Unresectable Locally Advanced Pancreatic Adenocarcinoma? Results of a Phase 2 Study. Technol Cancer Res Treat. 2016;.
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.