Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety

Radiation Oncology

Michael J Pishvaian²  John L Marshall²  Patrick Jackson¹  Colin D Johnson⁴  Reena Jha⁵  Nadim Haddad⁷  Simeng Suy⁶  Siyuan Lei⁶  Liam Berzcel²  Lisa Ley²  Aline Charabaty⁷  Gary Tse⁶  Rebecca Slack³  Sean P Collins⁶  Marie K Gurka⁶ 

[1]Department of Surgery, Georgetown University Hospital, 20007, Washington, DC, USA

[2]Lombardi Comprehensive Cancer Center, Georgetown University, Podium B 3800 Reservoir Road, NW, 20007, Washington, DC, USA

[3]Department of Biostatistics, University of Texas MD Anderson Cancer Center, 77230, Houston, TX, USA

[4]University Surgical Unit, Southampton University Hospitals, Southampton, United Kingdom

[5]Department of Radiology, Georgetown University Hospital, 20007, Washington, DC, USA

[6]Department of Radiation Oncology, Georgetown University Hospital, 20007, Washington, DC, USA

[7]Division of Gastroenterology, Department of Medicine, Georgetown University Hospital, 20007, Washington, DC, USA

关键词: Upper endoscopy;    QLQ-PAN26;    QLQ-C30;    Quality of life;    CyberKnife;    SBRT;    Stereotactic body radiation therapy;    Radiation;    Gemcitabine;    Pancreatic cancer;   

Others  :  1154517
DOI  :  10.1186/1748-717X-8-44

 received in 2012-12-04, accepted in 2013-02-25,  发布年份 2013

【 摘 要 】

Background

Concurrent chemoradiation is a standard option for locally advanced pancreatic cancer (LAPC). Concurrent conventional radiation with full-dose gemcitabine has significant toxicity. Stereotactic body radiation therapy (SBRT) may provide the opportunity to administer radiation in a shorter time frame with similar efficacy and reduced toxicity. This Pilot study assessed the safety of concurrent full-dose gemcitabine with SBRT for LAPC.

Methods

Patients received gemcitabine, 1000 mg/m² for 6 cycles. During week 4 of cycle 1, patients received SBRT (25 Gy delivered in five consecutive daily fractions of 5 Gy prescribed to the 75-83% isodose line). Acute and late toxicities were assessed using NIH CTCAE v3. Tumor response was assessed by RECIST. Patients underwent an esophagogastroduodenoscopy at baseline, 2, and 6 months to assess the duodenal mucosa. Quality of life (QoL) data was collected before and after treatment using the QLQ-C30 and QLQ-PAN26 questionnaires.

Results

Between September 2009 and February 2011, 11 patients enrolled with one withdrawal during radiation therapy. Patients had grade 1 to 2 gastrointestinal toxicity from the start of SBRT to 2 weeks after treatment. There were no grade 3 or greater radiation-related toxicities or delays for cycle 2 of gemcitabine. On endoscopy, there were no grade 2 or higher mucosal toxicities. Two patients had a partial response. The median progression free and overall survival were 6.8 and 12.2 months, respectively. Global QoL did not change between baseline and immediately after radiation treatment.

Conclusions

SBRT with concurrent full dose gemcitabine is safe when administered to patients with LAPC. There is no delay in administration of radiation or chemotherapy, and radiation is completed with minimal toxicity.

【 授权许可】

   
2013 Gurka et al.; licensee BioMed Central Ltd.

【 图 表 】

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