Clinical outcomes following stereotactic body radiation therapy (SBRT) for non-resectable pancreatic adenocarcinoma

Abstract

Objectives

The purpose of this study was to report on progression-free survival (PFS), overall survival (OS), and related toxicities following stereotactic body radiation therapy (SBRT) for non-resectable pancreatic cancer (PCa).

Methods

The RSSearch® Patient Registry was screened for PCa patients treated with SBRT. The relationship between PFS, OS, and potential prognostic factors were evaluated using the Kaplan-Meier method and continuous log-rank analysis, and the correlation between treatment planning and toxicity incidence was examined by logistic regression.

Results

Sixty patients met inclusion criteria. Twenty-three patients (38.33%) had received adjuvant gemcitabine. Following SBRT, median PFS was 6.07 months (range: 2.33 - 34.4 months) and median OS was 8.55 months (range: 2.66 - 78.53 months). Single-fraction SBRT trended towards poorer median PFS (5.13 vs. 6.76 months; p = 0.0122) with no significant difference in median OS (10.3 vs. 7.17 months; p = 0.8896). PCas located in the head had a significantly higher median OS (9.58 months) as compared to those in the body (5.66 months; p = 0.0376). Adjuvant gemcitabine did not result in superior PFS (5.12 vs. 6.35 months; p = 0.52) or OS (8.67 vs. 7.07 months; p = 0.6010). Eight (13.3%) and six (10%) patients reported acute and late toxicities, respectively, that were all Grade 1 or 2. Single-fraction SBRT was associated with an increased risk of toxicity incidence (5/9 patients vs. 3/51 patients; p = 0.001).

Conclusion

SBRT was well-tolerated by PCa patients with fractionated SBRT trending towards superior PFS and less toxicity as compared to single-fraction SBRT.

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