Radiat Oncol J.  2018 Sep;36(3):200-209. 10.3857/roj.2018.00073.

Effectiveness and feasibility of concurrent chemoradiotherapy using simultaneous integrated boost-intensity modulated radiotherapy with and without induction chemotherapy for locally advanced pancreatic cancer

Affiliations
  • 1Proton Therapy Center, National Cancer Center Research Institute and Hospital, National Cancer Institute, Goyang, Korea. k2onco@ncc.re.kr
  • 2Center for Liver Cancer, National Cancer Center Research Institute and Hospital, National Cancer Institute, Goyang, Korea.

Abstract

PURPOSE
To evaluate the effectiveness and feasibility of chemoradiotherapy (CRT) using simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in locally advanced pancreatic cancer (LAPC) patients.
MATERIALS AND METHODS
Between January 2011 and May 2015, 47 LAPC patients received CRT using SIB-IMRT. Prior to SIB-IMRT, 37 patients (78.7%) received induction chemotherapy (IC-CRT group) and remaining 10 patients (21.3%) did not received induction chemotherapy (CRT group). During SIB-IMRT, all patients received concomitant chemotherapy, with gemcitabine (n = 37) and capecitabine (n = 10).
RESULTS
At the time of analysis, 45 patients had died and 2 patients remained alive and the median follow-up time was 14.2 months (range, 3.3 to 51.4 months). For all patients, the median times of local progression-free survival (LPFS), progression-free survival (PFS), and overall survival (OS) were 18.1, 10.3, and 14.2 months, respectively. The median time of LPFS between IC-CRT and CRT groups was similar (18.1 months vs. 18.3 months, p = 0.711). IC-CRT group had a higher trend in PFS (10.9 months vs. 4.1 months, p = 0.054) and had significantly higher OS (15.4 months vs. 9.5 months, p = 0.007) than CRT group. In multivariate analysis, the use of induction chemotherapy and tumor response were significant factors associated with OS (p < 0.05, each). During SIBIMRT, toxicity of grade ≥3 was observed in 7 patients (14.9%) in all patients.
CONCLUSIONS
CRT using SIB-IMRT is feasible and promising in LAPC patients.

Keyword

Pancreas neoplasms; Radiotherapy; Intensity-modulated radiotherapy; Survival

MeSH Terms

Capecitabine
Chemoradiotherapy*
Disease-Free Survival
Drug Therapy
Follow-Up Studies
Humans
Induction Chemotherapy*
Multivariate Analysis
Pancreatic Neoplasms*
Radiotherapy*
Radiotherapy, Intensity-Modulated
Capecitabine
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