Imaging-guided SMART improves survival in locally advanced and borderline resectable pancreatic cancer: a comparative study.

IF 2.9 3区医学 Q2 ONCOLOGY

American journal of cancer research Pub Date : 2025-06-15 eCollection Date: 2025-01-01 DOI:10.62347/XKSS2851

Nianhui Jiao, Huiqin Qi, Xuejun Li, Yongjie Qi, Yanjie Sun

{"title":"Imaging-guided SMART improves survival in locally advanced and borderline resectable pancreatic cancer: a comparative study.","authors":"Nianhui Jiao, Huiqin Qi, Xuejun Li, Yongjie Qi, Yanjie Sun","doi":"10.62347/XKSS2851","DOIUrl":null,"url":null,"abstract":"<p><p>Pancreatic cancer remains notoriously challenging to treat due to its aggressive nature and complex anatomic location. Late-stage diagnoses often result in high mortality rates. This study assesses the effectiveness of combining ablative stereotactic MRI-guided intensity-modulated radiation therapy (SMART) with chemotherapy for treating locally advanced and borderline resectable pancreatic cancer. We retrospectively analyzed 235 pancreatic cancer patients treated between 2020 and 2023. Patients were divided into chemoradiation (SMART + chemotherapy, n = 106) and chemotherapy-only (n = 129) groups. Key outcomes included progression-free survival, overall survival, margin-negative resection rates, lymphovascular invasion, and toxicities. The chemoradiation group demonstrated improved PFS (8.30 ± 1.20 vs. 7.90 ± 1.30 months, P = 0.015) and OS (14.30 ± 2.60 vs. 13.50 ± 2.40 months, P = 0.015), with higher rates of margin-negative resections (92.45% vs. 80.62%, P = 0.009) and reduced LVI (37.74% vs. 52.71%, P = 0.022) compared to chemotherapy alone. However, acute toxicities, including fatigue and abdominal pain, were more frequent in the chemoradiation group. Locoregional control and distant metastasis-free survival showed no significant group differences (P > 0.05). Overall, SMART enhances local tumor control and survival outcomes in severe pancreatic cancer, albeit with increased acute toxicity.</p>","PeriodicalId":7437,"journal":{"name":"American journal of cancer research","volume":"15 6","pages":"2604-2617"},"PeriodicalIF":2.9000,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256400/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of cancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.62347/XKSS2851","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Pancreatic cancer remains notoriously challenging to treat due to its aggressive nature and complex anatomic location. Late-stage diagnoses often result in high mortality rates. This study assesses the effectiveness of combining ablative stereotactic MRI-guided intensity-modulated radiation therapy (SMART) with chemotherapy for treating locally advanced and borderline resectable pancreatic cancer. We retrospectively analyzed 235 pancreatic cancer patients treated between 2020 and 2023. Patients were divided into chemoradiation (SMART + chemotherapy, n = 106) and chemotherapy-only (n = 129) groups. Key outcomes included progression-free survival, overall survival, margin-negative resection rates, lymphovascular invasion, and toxicities. The chemoradiation group demonstrated improved PFS (8.30 ± 1.20 vs. 7.90 ± 1.30 months, P = 0.015) and OS (14.30 ± 2.60 vs. 13.50 ± 2.40 months, P = 0.015), with higher rates of margin-negative resections (92.45% vs. 80.62%, P = 0.009) and reduced LVI (37.74% vs. 52.71%, P = 0.022) compared to chemotherapy alone. However, acute toxicities, including fatigue and abdominal pain, were more frequent in the chemoradiation group. Locoregional control and distant metastasis-free survival showed no significant group differences (P > 0.05). Overall, SMART enhances local tumor control and survival outcomes in severe pancreatic cancer, albeit with increased acute toxicity.

查看原文本刊更多论文

成像引导下的SMART提高局部晚期和交界性可切除胰腺癌的生存率：一项比较研究。

由于胰腺癌的侵袭性和复杂的解剖位置，治疗胰腺癌仍然是众所周知的挑战。晚期诊断往往导致高死亡率。本研究评估了消融立体定向mri引导下调强放疗（SMART）联合化疗治疗局部晚期和交界性可切除胰腺癌的有效性。我们回顾性分析了2020年至2023年间接受治疗的235例胰腺癌患者。将患者分为放化疗组（106例SMART +化疗）和单纯化疗组（129例）。主要结局包括无进展生存期、总生存期、边缘阴性切除率、淋巴血管侵袭和毒性。放化疗组PFS（8.30±1.20个月vs. 7.90±1.30个月，P = 0.015）和OS（14.30±2.60个月vs. 13.50±2.40个月，P = 0.015）改善，边缘阴性切除率（92.45% vs. 80.62%, P = 0.009）和LVI降低（37.74% vs. 52.71%, P = 0.022）高于单纯化疗组。然而，急性毒性，包括疲劳和腹痛，在放化疗组更常见。局部对照和远处无转移生存率组间差异无统计学意义（P < 0.05）。总体而言，SMART增强了严重胰腺癌的局部肿瘤控制和生存结果，尽管急性毒性增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American journal of cancer research ONCOLOGY-

自引率

3.80%

发文量

263

期刊介绍： The American Journal of Cancer Research (AJCR) (ISSN 2156-6976), is an independent open access, online only journal to facilitate rapid dissemination of novel discoveries in basic science and treatment of cancer. It was founded by a group of scientists for cancer research and clinical academic oncologists from around the world, who are devoted to the promotion and advancement of our understanding of the cancer and its treatment. The scope of AJCR is intended to encompass that of multi-disciplinary researchers from any scientific discipline where the primary focus of the research is to increase and integrate knowledge about etiology and molecular mechanisms of carcinogenesis with the ultimate aim of advancing the cure and prevention of this increasingly devastating disease. To achieve these aims AJCR will publish review articles, original articles and new techniques in cancer research and therapy. It will also publish hypothesis, case reports and letter to the editor. Unlike most other open access online journals, AJCR will keep most of the traditional features of paper print that we are all familiar with, such as continuous volume, issue numbers, as well as continuous page numbers to retain our comfortable familiarity towards an academic journal.