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Prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer
The role of stereotactic body radiation therapy for the elderly with advanced or medically inoperable pancreatic cancer was still debated. Therefore, we evaluated the value of stereotactic body radiation therapy and its association with survival of those patients. A total of 417 elderly patients wer...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633558/ https://www.ncbi.nlm.nih.gov/pubmed/28834410 http://dx.doi.org/10.1002/cam4.1164 |
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author | Zhu, Xiaofei Li, Fuqi Ju, Xiaoping Cao, Fei Cao, Yangsen Fang, Fang Qing, Shuiwang Shen, Yuxin Jia, Zhen Zhang, Huojun |
author_facet | Zhu, Xiaofei Li, Fuqi Ju, Xiaoping Cao, Fei Cao, Yangsen Fang, Fang Qing, Shuiwang Shen, Yuxin Jia, Zhen Zhang, Huojun |
author_sort | Zhu, Xiaofei |
collection | PubMed |
description | The role of stereotactic body radiation therapy for the elderly with advanced or medically inoperable pancreatic cancer was still debated. Therefore, we evaluated the value of stereotactic body radiation therapy and its association with survival of those patients. A total of 417 elderly patients were retrospectively reviewed from 2012 to 2015. Overall survival (OS), progression‐free survival (PFS), local recurrence‐free survival (LRFS), distant metastasis‐free survival (DMFS), and toxicities were analyzed. Prescription doses ranged from 30–46.8 Gy in 5–8 fractions. Median age was 73 years old. Median OS, PFS, LRFS, and DMFS were 10, 8, 10, and 9.5 months, respectively. One‐year OS, PFS, LRFS, and DMFS rate were 35.5%, 18.2%, 26.6%, and 27.1%, respectively. Tumor stage and tumor response at 6 months and CA19‐9 levels normalization at 3 months after treatment were independent predictors of OS, PFS, LRFS, and DMFS. Patients with early‐stage cancer, better tumor response, and normalization of CA19‐9 levels had significantly longer OS, PFS, LRFS, and DMFS. Patients with the prodrug of 5‐FU and radiotherapy had longer survival than those with gemcitabine‐based chemotherapy and radiotherapy. Patients who received BED (10) ≥ 60 Gy achieved better tumor response compared with those who received BED (10) < 60 Gy. Two patients had grade 4 intestinal strictures. No grade 3 or higher hematologic toxicities occurred. Stereotactic body radiation therapy is safe and effective for elderly patients with advanced or medically inoperable pancreatic cancer. Early efficacy could be predictive of prognosis. Higher doses may be associated with efficacy but need further investigation. |
format | Online Article Text |
id | pubmed-5633558 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-56335582017-10-17 Prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer Zhu, Xiaofei Li, Fuqi Ju, Xiaoping Cao, Fei Cao, Yangsen Fang, Fang Qing, Shuiwang Shen, Yuxin Jia, Zhen Zhang, Huojun Cancer Med Clinical Cancer Research The role of stereotactic body radiation therapy for the elderly with advanced or medically inoperable pancreatic cancer was still debated. Therefore, we evaluated the value of stereotactic body radiation therapy and its association with survival of those patients. A total of 417 elderly patients were retrospectively reviewed from 2012 to 2015. Overall survival (OS), progression‐free survival (PFS), local recurrence‐free survival (LRFS), distant metastasis‐free survival (DMFS), and toxicities were analyzed. Prescription doses ranged from 30–46.8 Gy in 5–8 fractions. Median age was 73 years old. Median OS, PFS, LRFS, and DMFS were 10, 8, 10, and 9.5 months, respectively. One‐year OS, PFS, LRFS, and DMFS rate were 35.5%, 18.2%, 26.6%, and 27.1%, respectively. Tumor stage and tumor response at 6 months and CA19‐9 levels normalization at 3 months after treatment were independent predictors of OS, PFS, LRFS, and DMFS. Patients with early‐stage cancer, better tumor response, and normalization of CA19‐9 levels had significantly longer OS, PFS, LRFS, and DMFS. Patients with the prodrug of 5‐FU and radiotherapy had longer survival than those with gemcitabine‐based chemotherapy and radiotherapy. Patients who received BED (10) ≥ 60 Gy achieved better tumor response compared with those who received BED (10) < 60 Gy. Two patients had grade 4 intestinal strictures. No grade 3 or higher hematologic toxicities occurred. Stereotactic body radiation therapy is safe and effective for elderly patients with advanced or medically inoperable pancreatic cancer. Early efficacy could be predictive of prognosis. Higher doses may be associated with efficacy but need further investigation. John Wiley and Sons Inc. 2017-08-23 /pmc/articles/PMC5633558/ /pubmed/28834410 http://dx.doi.org/10.1002/cam4.1164 Text en © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Zhu, Xiaofei Li, Fuqi Ju, Xiaoping Cao, Fei Cao, Yangsen Fang, Fang Qing, Shuiwang Shen, Yuxin Jia, Zhen Zhang, Huojun Prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer |
title | Prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer |
title_full | Prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer |
title_fullStr | Prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer |
title_full_unstemmed | Prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer |
title_short | Prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer |
title_sort | prognostic role of stereotactic body radiation therapy for elderly patients with advanced and medically inoperable pancreatic cancer |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633558/ https://www.ncbi.nlm.nih.gov/pubmed/28834410 http://dx.doi.org/10.1002/cam4.1164 |
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