Stereotactic body radiotherapy for unresectable or locally recurrent pancreatic cancer: A single centre experience.

Abstract

Purpose: To refer our experience with stereotactic body radiotherapy (SBRT) in patients with pancreatic cancer.

Materials and methods: 45 Patients with unresectable or locally recurrent pancreatic cancer after primary surgery, were submitted to SBRT. Toxicities were graded according to CTCAE version 5. Statistical analysis was performed by the Kaplan-Meier method.

Results: The characteristics of the patients were median age 70 years (range, 46-84 years), median KPS 90% (range, 80-90%). Six patients had recurrent cancer after surgery, the other 39 patients were unresectable. Median radiation dose was 35 Gy (range, 27-40 Gy) delivered in 5 fractions. Simultaneous integrated boost with median dose of 35 Gy (range, 30-45 Gy) was given in 7 patients.After median follow-up of 10 months (range, 3-61 months) median local control was 10 months (range,5-15 months) and 49% (±8%) at 1-year. Median overall survival (OS) was 10 months (range,7-14 months), 38 % (±7%) at 1 year. Type of radiological response statistically significant influenced LC and OS, stage only LC in non-significant way. Clinical response was obtained in 12 of 36 (33%) cases. Median Numeric Rating Scale (NRS) was 7 (range, 4-8) before radiotherapy and 1 (range, 0-5) post SBRT. Acute G1-2 gastrointestinal toxicities were registered in 15% of patients, no late toxicities were found.

Conclusion: In our series we obtained a good local palliation with SBRT that is a safe and effective treatment option. Higher doses could be administered in selected patients to obtain better response to treatment that is correlated with LC and OS.