Stereotactic body radiation therapy boost in locally advanced pancreatic cancer.
OBJECTIVE
To investigate the clinical application of a stereotactic body radiation therapy (SBRT) boost in locally advanced pancreatic cancer patients with a focus on local efficacy and toxicity.


METHODS
We retrospectively reviewed 30 patients with locally advanced and nonmetastatic pancreatic cancer who had been treated between 2004 and 2006. Follow-up duration ranged from 4 to 41 months (median, 14.5 months). A total dose of 40 Gy was delivered in 20 fractions using a conventional three-field technique, and then a single fraction of 14, 15, 16, or 17 Gy SBRT was administered as a boost without a break. Twenty-one patients received chemotherapy. Overall and local progression-free survival were calculated and prognostic factors were evaluated.


RESULTS
One-year overall survival and local progression-free survival rates were 60.0% and 70.2%, respectively. One patient (3%) developed Grade 4 toxicity. Carbohydrate antigen 19-9 response was found to be an independent prognostic factor for survival.


CONCLUSIONS
Our findings indicate that a SBRT boost provides a safe means of increasing radiation dose. Based on the results of this study, we recommend that a well controlled Phase II study be conducted on locally advanced pancreatic cancer.
Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
Youngseok
Y
Seo
Mi-Sook
MS
Kim
Sungyul
S
Yoo
Chulkoo
C
Cho
Kwangmo
K
Yang
Hyungjun
H
Yoo
Chulwon
C
Choi
Donghan
D
Lee
Jin
J
Kim
Min Suk
MS
Kim
Hyejin
H
Kang
Younghan
Y
Kim
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018395:CA-19-9 Antigen / Q000097:blood; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D049268:Positron-Emission Tomography / Q000379:methods; D011725:Pyridines / Q000008:administration & dosage; D016634:Radiosurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D005641:Tegafur / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden
D018395:CA-19-9 Antigen; D011725:Pyridines; D005641:Tegafur; D010094:Oxonic Acid; C104201:gimeracil