Stereotactic body radiation therapy for locally advanced pancreatic cancer.
<h4>Purpose</h4>Stereotactic body radiation therapy (SBRT) is a promising treatment modality for locally advanced pancreatic cancer (LAPC). We evaluated the clinical outcomes of SBRT in patients with LAPC.<h4>Patients and methods</h4>We retrospectively analyzed the medical re...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0214970 |
| _version_ | 1819142366685036544 |
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| author | Jinhong Jung Sang Min Yoon Jin-Hong Park Dong-Wan Seo Sang Soo Lee Myung-Hwan Kim Sung Koo Lee Do Hyun Park Tae Jun Song Baek-Yeol Ryoo Heung-Moon Chang Kyu-Pyo Kim Changhoon Yoo Jae Ho Jeong Song Cheol Kim Dae Wook Hwang Jae Hoon Lee Ki Byung Song Yoon Young Jo Jongmoo Park Jong Hoon Kim |
| author_facet | Jinhong Jung Sang Min Yoon Jin-Hong Park Dong-Wan Seo Sang Soo Lee Myung-Hwan Kim Sung Koo Lee Do Hyun Park Tae Jun Song Baek-Yeol Ryoo Heung-Moon Chang Kyu-Pyo Kim Changhoon Yoo Jae Ho Jeong Song Cheol Kim Dae Wook Hwang Jae Hoon Lee Ki Byung Song Yoon Young Jo Jongmoo Park Jong Hoon Kim |
| author_sort | Jinhong Jung |
| collection | DOAJ |
| description | <h4>Purpose</h4>Stereotactic body radiation therapy (SBRT) is a promising treatment modality for locally advanced pancreatic cancer (LAPC). We evaluated the clinical outcomes of SBRT in patients with LAPC.<h4>Patients and methods</h4>We retrospectively analyzed the medical records of patients with LAPC who underwent SBRT at our institution between April 2011 and July 2016. Fiducial markers were implanted using endoscopic ultrasound guidance one week prior to 4-dimensional computed tomography (CT) simulation and daily cone beam CT was used for image guidance. Patients received volumetric modulated arc therapy or intensity modulated radiotherapy using respiratory gating technique. A median dose of 28 Gy (range, 24-36 Gy) was given over four consecutive fractions delivered within one week. Survival outcomes including freedom from local disease progression (FFLP), progression-free survival (PFS), and overall survival (OS) were analyzed. Acute and late toxicities related to SBRT were assessed.<h4>Results</h4>A total of 95 patients with LAPC were analyzed, 52 of which (54.7%) had pancreatic head cancers. Most (94.7%) had received gemcitabine-based chemotherapy. The 1-year FFLP rate was 80.1%. Median OS and PFS were 16.7 months and 10.2 months, respectively; the 1-year OS and PFS rates were 67.4% and 42.9%, respectively. Among 79 patients who experienced failure, the sites of first failures were isolated local progressions in 12 patients (15.2%), distant metastasis in 55 patients (69.6%), and both in 12 patients (15.2%). Seven patients (7.4%) were able to undergo surgical resection after SBRT and four had margin-negative resections. Three patients (3.2%) had grade 3 nausea/vomiting during SBRT, and late grade 3 toxicity was observed in another three patients.<h4>Conclusions</h4>LAPC patients who received chemotherapy and SBRT had favorable FFLP and OS with minimal treatment-related toxicity. The most common pattern of failure was distant metastasis, which warrants further studies on the optimal scheme of chemotherapy and SBRT. |
| first_indexed | 2024-12-22T12:09:12Z |
| format | Article |
| id | doaj.art-2c4bac8612c34a29a2becc9b4aa097d7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T12:09:12Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2c4bac8612c34a29a2becc9b4aa097d72022-12-21T18:26:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01144e021497010.1371/journal.pone.0214970Stereotactic body radiation therapy for locally advanced pancreatic cancer.Jinhong JungSang Min YoonJin-Hong ParkDong-Wan SeoSang Soo LeeMyung-Hwan KimSung Koo LeeDo Hyun ParkTae Jun SongBaek-Yeol RyooHeung-Moon ChangKyu-Pyo KimChanghoon YooJae Ho JeongSong Cheol KimDae Wook HwangJae Hoon LeeKi Byung SongYoon Young JoJongmoo ParkJong Hoon Kim<h4>Purpose</h4>Stereotactic body radiation therapy (SBRT) is a promising treatment modality for locally advanced pancreatic cancer (LAPC). We evaluated the clinical outcomes of SBRT in patients with LAPC.<h4>Patients and methods</h4>We retrospectively analyzed the medical records of patients with LAPC who underwent SBRT at our institution between April 2011 and July 2016. Fiducial markers were implanted using endoscopic ultrasound guidance one week prior to 4-dimensional computed tomography (CT) simulation and daily cone beam CT was used for image guidance. Patients received volumetric modulated arc therapy or intensity modulated radiotherapy using respiratory gating technique. A median dose of 28 Gy (range, 24-36 Gy) was given over four consecutive fractions delivered within one week. Survival outcomes including freedom from local disease progression (FFLP), progression-free survival (PFS), and overall survival (OS) were analyzed. Acute and late toxicities related to SBRT were assessed.<h4>Results</h4>A total of 95 patients with LAPC were analyzed, 52 of which (54.7%) had pancreatic head cancers. Most (94.7%) had received gemcitabine-based chemotherapy. The 1-year FFLP rate was 80.1%. Median OS and PFS were 16.7 months and 10.2 months, respectively; the 1-year OS and PFS rates were 67.4% and 42.9%, respectively. Among 79 patients who experienced failure, the sites of first failures were isolated local progressions in 12 patients (15.2%), distant metastasis in 55 patients (69.6%), and both in 12 patients (15.2%). Seven patients (7.4%) were able to undergo surgical resection after SBRT and four had margin-negative resections. Three patients (3.2%) had grade 3 nausea/vomiting during SBRT, and late grade 3 toxicity was observed in another three patients.<h4>Conclusions</h4>LAPC patients who received chemotherapy and SBRT had favorable FFLP and OS with minimal treatment-related toxicity. The most common pattern of failure was distant metastasis, which warrants further studies on the optimal scheme of chemotherapy and SBRT.https://doi.org/10.1371/journal.pone.0214970 |
| spellingShingle | Jinhong Jung Sang Min Yoon Jin-Hong Park Dong-Wan Seo Sang Soo Lee Myung-Hwan Kim Sung Koo Lee Do Hyun Park Tae Jun Song Baek-Yeol Ryoo Heung-Moon Chang Kyu-Pyo Kim Changhoon Yoo Jae Ho Jeong Song Cheol Kim Dae Wook Hwang Jae Hoon Lee Ki Byung Song Yoon Young Jo Jongmoo Park Jong Hoon Kim Stereotactic body radiation therapy for locally advanced pancreatic cancer. PLoS ONE |
| title | Stereotactic body radiation therapy for locally advanced pancreatic cancer. |
| title_full | Stereotactic body radiation therapy for locally advanced pancreatic cancer. |
| title_fullStr | Stereotactic body radiation therapy for locally advanced pancreatic cancer. |
| title_full_unstemmed | Stereotactic body radiation therapy for locally advanced pancreatic cancer. |
| title_short | Stereotactic body radiation therapy for locally advanced pancreatic cancer. |
| title_sort | stereotactic body radiation therapy for locally advanced pancreatic cancer |
| url | https://doi.org/10.1371/journal.pone.0214970 |
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