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Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma

OBJECTIVES: The role of radiation therapy in the management of unresectable pancreatic cancer is controversial. One concern about concurrent chemoradiation relates to the timing of chemotherapy. In contrast to conventional radiation therapy, stereotactic body radiation therapy (SBRT) delivers high d...

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Autores principales: Gurka, Marie K., Kim, Christine, He, Aiwu Ruth, Charabaty, Aline, Haddad, Nadim, Turocy, Jenna, Johnson, Lynt, Jackson, Patrick, Weiner, Louis M., Marshall, John L., Collins, Sean P., Pishvaian, Michael J., Unger, Keith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418949/
https://www.ncbi.nlm.nih.gov/pubmed/25171298
http://dx.doi.org/10.1097/COC.0000000000000118
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author Gurka, Marie K.
Kim, Christine
He, Aiwu Ruth
Charabaty, Aline
Haddad, Nadim
Turocy, Jenna
Johnson, Lynt
Jackson, Patrick
Weiner, Louis M.
Marshall, John L.
Collins, Sean P.
Pishvaian, Michael J.
Unger, Keith
author_facet Gurka, Marie K.
Kim, Christine
He, Aiwu Ruth
Charabaty, Aline
Haddad, Nadim
Turocy, Jenna
Johnson, Lynt
Jackson, Patrick
Weiner, Louis M.
Marshall, John L.
Collins, Sean P.
Pishvaian, Michael J.
Unger, Keith
author_sort Gurka, Marie K.
collection PubMed
description OBJECTIVES: The role of radiation therapy in the management of unresectable pancreatic cancer is controversial. One concern about concurrent chemoradiation relates to the timing of chemotherapy. In contrast to conventional radiation therapy, stereotactic body radiation therapy (SBRT) delivers high doses in a shorter duration resulting in minimal disruption in chemotherapy. Here, we report our results of patients treated with SBRT and chemotherapy for inoperable pancreatic cancer. MATERIALS AND METHODS: Thirty-eight patients treated with SBRT and chemotherapy for locally advanced, borderline resectable, and medically inoperable pancreatic cancer at our institution from January 2008 to December 2012 were included in this retrospective analysis. Treatment was delivered in 5 fractions of 5 or 6 Gy per fraction over 5 days. Toxicities were scored using the Common Terminology Criteria for Adverse Events version 3. Survival was calculated using the Kaplan-Meier method. RESULTS: The median age was 70 years (range, 45 to 90 y). Eastern Cooperative Oncology Group performance status ranged from 0 to 3. Thirty-four patients received concurrent chemotherapy. Four patients received sequential chemotherapy. Median overall survival was 14.3 months and median progression-free survival was 9.2 months from diagnosis. From radiation, overall survival and progression-free survival were 12.3 and 6.8 months, respectively. The overall local control rate was 79%. Acute toxicity was minimal. Severe late SBRT-related toxicities included 1 grade 3 gastric outlet obstruction, 1 grade 4 biliary stricture, and 1 grade 5 gastric hemorrhage. CONCLUSIONS: SBRT combined with chemotherapy for unresectable pancreatic cancer is convenient, feasible, and generally well tolerated. Outcomes of SBRT combined with chemotherapy compare favorably to results obtained with chemotherapy and conventional radiation therapy.
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spelling pubmed-44189492017-04-01 Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma Gurka, Marie K. Kim, Christine He, Aiwu Ruth Charabaty, Aline Haddad, Nadim Turocy, Jenna Johnson, Lynt Jackson, Patrick Weiner, Louis M. Marshall, John L. Collins, Sean P. Pishvaian, Michael J. Unger, Keith Am J Clin Oncol Original Articles: Gastrointestinal OBJECTIVES: The role of radiation therapy in the management of unresectable pancreatic cancer is controversial. One concern about concurrent chemoradiation relates to the timing of chemotherapy. In contrast to conventional radiation therapy, stereotactic body radiation therapy (SBRT) delivers high doses in a shorter duration resulting in minimal disruption in chemotherapy. Here, we report our results of patients treated with SBRT and chemotherapy for inoperable pancreatic cancer. MATERIALS AND METHODS: Thirty-eight patients treated with SBRT and chemotherapy for locally advanced, borderline resectable, and medically inoperable pancreatic cancer at our institution from January 2008 to December 2012 were included in this retrospective analysis. Treatment was delivered in 5 fractions of 5 or 6 Gy per fraction over 5 days. Toxicities were scored using the Common Terminology Criteria for Adverse Events version 3. Survival was calculated using the Kaplan-Meier method. RESULTS: The median age was 70 years (range, 45 to 90 y). Eastern Cooperative Oncology Group performance status ranged from 0 to 3. Thirty-four patients received concurrent chemotherapy. Four patients received sequential chemotherapy. Median overall survival was 14.3 months and median progression-free survival was 9.2 months from diagnosis. From radiation, overall survival and progression-free survival were 12.3 and 6.8 months, respectively. The overall local control rate was 79%. Acute toxicity was minimal. Severe late SBRT-related toxicities included 1 grade 3 gastric outlet obstruction, 1 grade 4 biliary stricture, and 1 grade 5 gastric hemorrhage. CONCLUSIONS: SBRT combined with chemotherapy for unresectable pancreatic cancer is convenient, feasible, and generally well tolerated. Outcomes of SBRT combined with chemotherapy compare favorably to results obtained with chemotherapy and conventional radiation therapy. Lippincott Williams & Wilkins 2017-04 2014-09-30 /pmc/articles/PMC4418949/ /pubmed/25171298 http://dx.doi.org/10.1097/COC.0000000000000118 Text en Copyright © 2014 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Articles: Gastrointestinal
Gurka, Marie K.
Kim, Christine
He, Aiwu Ruth
Charabaty, Aline
Haddad, Nadim
Turocy, Jenna
Johnson, Lynt
Jackson, Patrick
Weiner, Louis M.
Marshall, John L.
Collins, Sean P.
Pishvaian, Michael J.
Unger, Keith
Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma
title Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma
title_full Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma
title_fullStr Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma
title_full_unstemmed Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma
title_short Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma
title_sort stereotactic body radiation therapy (sbrt) combined with chemotherapy for unresected pancreatic adenocarcinoma
topic Original Articles: Gastrointestinal
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418949/
https://www.ncbi.nlm.nih.gov/pubmed/25171298
http://dx.doi.org/10.1097/COC.0000000000000118
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