Can Stereotactic Body Radiation Therapy Be a Viable and Efficient Therapeutic Option for Unresectable Locally Advanced Pancreatic Adenocarcinoma? Results of a Phase 2 Study.
To assess the efficacy of stereotactic body radiotherapy in patients with unresectable locally advanced pancreatic cancer.



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.



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.



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.
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
Tiziana
T
Comito
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
L
L
Cozzi
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
E
E
Clerici
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
C
C
Franzese
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
A
A
Tozzi
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
C
C
Iftode
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
P
P
Navarria
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
G
G
D'Agostino
2 Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy.
L
L
Rimassa
2 Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy.
C
C
Carnaghi
2 Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy.
N
N
Personeni
2 Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy.
M C
MC
Tronconi
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
F
F
De Rose
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
D
D
Franceschini
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
A M
AM
Ascolese
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
A
A
Fogliata
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
S
S
Tomatis
2 Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy.
A
A
Santoro
3 Pancreatic Surgery, Istituto Clinico Humanitas, Milano, Italy.
A
A
Zerbi
1 Radiotherapy, Istituto Clinico Humanitas, Milano, Italy.
M
M
Scorsetti
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage; D018450:Disease Progression; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016634:Radiosurgery / Q000379:methods*
D003841:Deoxycytidine
RapidArc; SBRT; pancreas cancer; phase II trial