PMID- 23562768
OWN - NLM
STAT- MEDLINE
DCOM- 20130725
LR  - 20220408
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 86
IP  - 3
DP  - 2013 Jul 1
TI  - Stereotactic body radiation therapy for locally advanced and borderline 
      resectable pancreatic cancer is effective and well tolerated.
PG  - 516-22
LID - S0360-3016(13)00214-9 [pii]
LID - 10.1016/j.ijrobp.2013.02.022 [doi]
AB  - PURPOSE: Stereotactic body radiation therapy (SBRT) provides high rates of local 
      control (LC) and margin-negative (R0) resections for locally advanced pancreatic 
      cancer (LAPC) and borderline resectable pancreatic cancer (BRPC), respectively, 
      with minimal toxicity. METHODS AND MATERIALS: A single-institution retrospective 
      review was performed for patients with nonmetastatic pancreatic cancer treated 
      with induction chemotherapy followed by SBRT. SBRT was delivered over 5 
      consecutive fractions using a dose painting technique including 7-10 Gy/fraction 
      to the region of vessel abutment or encasement and 5-6 Gy/fraction to the 
      remainder of the tumor. Restaging scans were performed at 4 weeks, and resectable 
      patients were considered for resection. The primary endpoints were overall 
      survival (OS) and progression-free survival (PFS). RESULTS: Seventy-three 
      patients were evaluated, with a median follow-up time of 10.5 months. Median 
      doses of 35 Gy and 25 Gy were delivered to the region of vessel involvement and 
      the remainder of the tumor, respectively. Thirty-two BRPC patients (56.1%) 
      underwent surgery, with 31 undergoing an R0 resection (96.9%). The median OS, 
      1-year OS, median PFS, and 1-year PFS for BRPC versus LAPC patients was 16.4 
      months versus 15 months, 72.2% versus 68.1%, 9.7 versus 9.8 months, and 42.8% 
      versus 41%, respectively (all P>.10). BRPC patients who underwent R0 resection 
      had improved median OS (19.3 vs 12.3 months; P=.03), 1-year OS (84.2% vs 58.3%; 
      P=.03), and 1-year PFS (56.5% vs 25.0%; P<.0001), respectively, compared with all 
      nonsurgical patients. The 1-year LC in nonsurgical patients was 81%. We did not 
      observe acute grade >/=3 toxicity, and late grade >/=3 toxicity was minimal (5.3%). 
      CONCLUSIONS: SBRT safely facilitates margin-negative resection in patients with 
      BRPC pancreatic cancer while maintaining a high rate of LC in unresectable 
      patients. These data support the expanded implementation of SBRT for pancreatic 
      cancer.
CI  - Copyright (c) 2013. Published by Elsevier Inc.
FAU - Chuong, Michael D
AU  - Chuong MD
AD  - Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL 33612, 
      USA.
FAU - Springett, Gregory M
AU  - Springett GM
FAU - Freilich, Jessica M
AU  - Freilich JM
FAU - Park, Catherine K
AU  - Park CK
FAU - Weber, Jill M
AU  - Weber JM
FAU - Mellon, Eric A
AU  - Mellon EA
FAU - Hodul, Pamela J
AU  - Hodul PJ
FAU - Malafa, Mokenge P
AU  - Malafa MP
FAU - Meredith, Kenneth L
AU  - Meredith KL
FAU - Hoffe, Sarah E
AU  - Hoffe SE
FAU - Shridhar, Ravi
AU  - Shridhar R
LA  - eng
PT  - Journal Article
DEP - 20130405
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chemotherapy, Adjuvant/methods
MH  - Disease-Free Survival
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Fiducial Markers
MH  - Four-Dimensional Computed Tomography
MH  - Humans
MH  - Induction Chemotherapy/methods
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Pancreatic Neoplasms/drug therapy/mortality/pathology/*surgery
MH  - Radiosurgery/*methods/mortality
MH  - Radiotherapy Planning, Computer-Assisted
MH  - Retrospective Studies
EDAT- 2013/04/09 06:00
MHDA- 2013/07/26 06:00
CRDT- 2013/04/09 06:00
PHST- 2012/08/23 00:00 [received]
PHST- 2013/02/08 00:00 [revised]
PHST- 2013/02/16 00:00 [accepted]
PHST- 2013/04/09 06:00 [entrez]
PHST- 2013/04/09 06:00 [pubmed]
PHST- 2013/07/26 06:00 [medline]
AID - S0360-3016(13)00214-9 [pii]
AID - 10.1016/j.ijrobp.2013.02.022 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2013 Jul 1;86(3):516-22. doi: 
      10.1016/j.ijrobp.2013.02.022. Epub 2013 Apr 5.