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Journal article
Stereotactic body radiotherapy for locally-advanced unresectable pancreatic cancer-patterns of care and overall survival
Journal of gastrointestinal oncology, v 8(5), pp 766-777
01 Oct 2017
PMID: 29184680
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Unresectable pancreatic cancer remains a challenging disease to treat. Stereotactic body radiotherapy (SBRT) allows for a higher biologically equivalent dose in an abbreviated course more convenient for patients and the integration of systemic therapy. We sought to investigate utilization trends and survival outcomes for patients treated with pancreatic SBRT versus conventionally fractionated radiotherapy (CFRT).
Methods: We engaged the National Cancer Database (NCDB) from 1998-2012 and identified locallyadvanced unresectable patients with histologically confirmed, non-metastatic, pancreatic adenocarcinoma who received radiotherapy. Patients who received CFRT (1.5-4.0 Gy per fraction to a dose of =45 Gy, n=11,879) were compared to those who received SBRT (6-15 Gy per fraction to a dose of =20 Gy, n=474).
Results: Median follow-up was 11.0 months (18.4 months for survivors). SBRT utilization increased from 0.2% to 7.4% from 1998 to 2012 (P< 0.05). On multivariable analysis, factors predictive for preferential utilization of SBRT over CFRT were later year of diagnosis, age =75 years, increased facility volume, and no chemotherapy in the initial treatment plan. Unadjusted median survival was 11.2 months for CFRT vs. 12.6 months for SBRT (P=0.002). Results were consistent in the propensity matched model. Variables predictive for improved survival on multivariable analysis were diagnosis after 2010, younger age, lower comorbidity score, tumor size < 3 cm, nodal stage zero, and receipt of chemotherapy (P<0.05).
Conclusions: SBRT utilization has increased significantly and is associated with a small absolute improvement in overall survival (OS) compared to CFRT. The decreased treatment time, without apparent compromise in survival, makes SBRT an attractive option for patients with unresectable pancreatic cancer warranting further research.
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Details
- Title
- Stereotactic body radiotherapy for locally-advanced unresectable pancreatic cancer-patterns of care and overall survival
- Creators
- Michael J. Dohopolski - University of PittsburghScott M. Glaser - UPMC Hillman Cancer CenterJohn A. Vargo - UPMC Hillman Cancer CenterGoundappa K. Balasubramani - University of PittsburghSushil Beriwal - UPMC Hillman Cancer Center
- Publication Details
- Journal of gastrointestinal oncology, v 8(5), pp 766-777
- Publisher
- AME PUBLISHING COMPANY
- Number of pages
- 12
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000413224600004
- Scopus ID
- 2-s2.0-85031692138
- Other Identifier
- 991021897363204721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Gastroenterology & Hepatology
- Oncology