Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohort
BackgroundThe role of stereotactic ablative radiation therapy (SABR) as local treatment option after chemotherapy for locally advanced pancreatic cancer (LAPC) is evolving. However adequate patient selection criteria for SABR in patients with LAPC are lacking.MethodsA prospective institutional datab...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1149961/full |
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| author | D. Doppenberg D. Doppenberg D. Doppenberg F. J. Lagerwaard F. J. Lagerwaard S. van Dieren M. R. Meijerink M. R. Meijerink J. J. van der Vliet J. J. van der Vliet J. J. van der Vliet M. G. Besselink M. G. Besselink G. van Tienhoven G. van Tienhoven E. Versteijne E. Versteijne B. J. Slotman B. J. Slotman J. W. Wilmink J. W. Wilmink G. Kazemier G. Kazemier A. M. E. Bruynzeel A. M. E. Bruynzeel |
| author_facet | D. Doppenberg D. Doppenberg D. Doppenberg F. J. Lagerwaard F. J. Lagerwaard S. van Dieren M. R. Meijerink M. R. Meijerink J. J. van der Vliet J. J. van der Vliet J. J. van der Vliet M. G. Besselink M. G. Besselink G. van Tienhoven G. van Tienhoven E. Versteijne E. Versteijne B. J. Slotman B. J. Slotman J. W. Wilmink J. W. Wilmink G. Kazemier G. Kazemier A. M. E. Bruynzeel A. M. E. Bruynzeel |
| author_sort | D. Doppenberg |
| collection | DOAJ |
| description | BackgroundThe role of stereotactic ablative radiation therapy (SABR) as local treatment option after chemotherapy for locally advanced pancreatic cancer (LAPC) is evolving. However adequate patient selection criteria for SABR in patients with LAPC are lacking.MethodsA prospective institutional database collected data of patients with LAPC treated with chemotherapy, mainly FOLFIRINOX, followed by SABR, which was delivered using magnetic resonance guided radiotherapy, 40 Gy in 5 fractions within two weeks. Primary endpoint was overall survival (OS). Cox regression analyses were performed to identify predictors for OS.ResultsOverall, 74 patients were included, median age 66 years, 45.9% had a KPS score of ≥90. Median OS was 19.6 months from diagnosis and 12.1 months from start of SABR. Local control was 90% at one year. Multivariable Cox regression analyses identified KPS ≥90, age <70, and absence of pain prior to SABR as independent favorable predictors for OS. The rate of grade ≥3 fatigue and late gastro-intestinal toxicity was 2.7%.ConclusionsSABR is a well-tolerated treatment in patients with unresectable LAPC following chemotherapy, with better outcomes when applied in patients with higher performance score, age <70 years and absence of pain. Future randomized trials will have to confirm these findings. |
| first_indexed | 2024-03-13T08:23:47Z |
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| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T08:23:47Z |
| publishDate | 2023-05-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-6e519831ffaa433896a1e76b9092b0f22023-05-31T04:52:42ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11499611149961Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohortD. Doppenberg0D. Doppenberg1D. Doppenberg2F. J. Lagerwaard3F. J. Lagerwaard4S. van Dieren5M. R. Meijerink6M. R. Meijerink7J. J. van der Vliet8J. J. van der Vliet9J. J. van der Vliet10M. G. Besselink11M. G. Besselink12G. van Tienhoven13G. van Tienhoven14E. Versteijne15E. Versteijne16B. J. Slotman17B. J. Slotman18J. W. Wilmink19J. W. Wilmink20G. Kazemier21G. Kazemier22A. M. E. Bruynzeel23A. M. E. Bruynzeel24Amsterdam UMC, Department of Radiation Oncology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Surgery, University of Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Radiation Oncology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Surgery, University of Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department Intervention Radiology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Medical Oncology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsLAVA Therapeutics, Utrecht, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Surgery, University of Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Radiation Oncology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Radiation Oncology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Radiation Oncology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Medical Oncology, University of Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Surgery, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsAmsterdam UMC, Department of Radiation Oncology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsCancer Center Amsterdam, Amsterdam, NetherlandsBackgroundThe role of stereotactic ablative radiation therapy (SABR) as local treatment option after chemotherapy for locally advanced pancreatic cancer (LAPC) is evolving. However adequate patient selection criteria for SABR in patients with LAPC are lacking.MethodsA prospective institutional database collected data of patients with LAPC treated with chemotherapy, mainly FOLFIRINOX, followed by SABR, which was delivered using magnetic resonance guided radiotherapy, 40 Gy in 5 fractions within two weeks. Primary endpoint was overall survival (OS). Cox regression analyses were performed to identify predictors for OS.ResultsOverall, 74 patients were included, median age 66 years, 45.9% had a KPS score of ≥90. Median OS was 19.6 months from diagnosis and 12.1 months from start of SABR. Local control was 90% at one year. Multivariable Cox regression analyses identified KPS ≥90, age <70, and absence of pain prior to SABR as independent favorable predictors for OS. The rate of grade ≥3 fatigue and late gastro-intestinal toxicity was 2.7%.ConclusionsSABR is a well-tolerated treatment in patients with unresectable LAPC following chemotherapy, with better outcomes when applied in patients with higher performance score, age <70 years and absence of pain. Future randomized trials will have to confirm these findings.https://www.frontiersin.org/articles/10.3389/fonc.2023.1149961/fullpancreatic cancerLAPCradiotherapySABRMRgRTpatient selection |
| spellingShingle | D. Doppenberg D. Doppenberg D. Doppenberg F. J. Lagerwaard F. J. Lagerwaard S. van Dieren M. R. Meijerink M. R. Meijerink J. J. van der Vliet J. J. van der Vliet J. J. van der Vliet M. G. Besselink M. G. Besselink G. van Tienhoven G. van Tienhoven E. Versteijne E. Versteijne B. J. Slotman B. J. Slotman J. W. Wilmink J. W. Wilmink G. Kazemier G. Kazemier A. M. E. Bruynzeel A. M. E. Bruynzeel Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohort Frontiers in Oncology pancreatic cancer LAPC radiotherapy SABR MRgRT patient selection |
| title | Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohort |
| title_full | Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohort |
| title_fullStr | Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohort |
| title_full_unstemmed | Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohort |
| title_short | Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohort |
| title_sort | optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy a single center prospective cohort |
| topic | pancreatic cancer LAPC radiotherapy SABR MRgRT patient selection |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1149961/full |
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