Proton radiotherapy as a treatment strategy to increase survival in locally advanced pancreatic cancer in the body and tail: a retrospective study

Radiation Oncology

Research

Masaki Suga¹  SungChul Park²  Daiki Takahashi²  Sunao Tokumaru²  Kazuki Terashima²  Yoshiro Matsuo²  Tomoaki Okimoto²  Hirochika Toyama³  Taisuke Okawa³  Yoshihide Nanno³  Jun Ishida³  Takumi Fukumoto³  Katsuya Ami⁴ 

[1] Department of Radiation Physics, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, 679-5165, Tatsuno, Hyogo, Japan;Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, 679-5165, Tatsuno, Hyogo, Japan;Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Hyogo, Japan;Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Hyogo, Japan;Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, 679-5165, Tatsuno, Hyogo, Japan;

关键词: Pancreatic cancer in the body and tail;    Locally advanced pancreatic cancer;    Proton radiotherapy;    Chemoradiotherapy;    Multidisciplinary treatment;    Prognostic factor;    Long-term survival outcome;    Retrospective study;   

DOI  :  10.1186/s13014-023-02301-9

 received in 2023-05-19, accepted in 2023-06-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLong-term outcomes and prognostic factors of proton radiotherapy for locally advanced pancreatic cancer (LAPC) in the body and tail are still unknown. The aim of this study was to determine the prognostic factors after proton radiotherapy in a large group of patients with LAPC in the body and tail.MethodsThe medical records of 200 patients with LAPC in the body and tail who underwent proton radiotherapy between February 2009 and January 2021 at the Hyogo Ion Beam Medical Center were retrospectively reviewed to identify prognostic factors that contribute to long-term survival.ResultsThe overall survival rate at 1- and 2-year after PT was 69.6% and 35.4% with a median overall survival of 18.4 months. The 1- and 2-year local progression-free, and progression-free survival rates were 84.3% and 68.0%, and 44.3% and 19.4%, respectively. In multivariate analysis, superior mesenteric artery (SMA) invasion (SMA only invasion vs. celiac artery only invasion; P = 0.049: SMA and celiac artery invasion vs. celiac artery only invasion; P = 0.017), carbohydrate antigen 19-9 (CA 19-9) level ≥ 231.9 U/mL (P = 0.001), anterior peripancreatic invasion (P = 0.006), and incomplete scheduled concurrent chemotherapy (P = 0.009) were statistically significant prognostic factors for overall survival. There was no significant difference in local progression-free survival; however, distant metastasis-free survival was statistically worse in patients with prognostic factors than in those without.ConclusionsProton radiotherapy for LAPC in the body and tail may be a valuable multidisciplinary treatment option. Patients with SMA invasion, higher pre-proton radiotherapy serum CA 19-9 level, anterior peripancreatic invasion, or incomplete scheduled concurrent chemotherapy had worse overall survival because of worse distant metastasis-free survival, suggesting that distant metastases have a significant impact on overall survival in such patients.Trial registration: Retrospectively registered.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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