INTRODUCTION: Pancreatic cancer carries a disproportionate burden of mortality and highlights a need to identify therapies that improve local control and survival outcomes. Radiotherapy is an option for the large proportion of patients who are surgically unresectable but has previously been restricted by surrounding dose-limiting organs. The use of stereotactic body radiotherapy (SBRT) can overcome these limitations and deliver a higher biologically equivalent dose to improve local control. METHODS: Eighty-seven patients with locally advanced, unresectable and histologically confirmed pancreatic adenocarcinoma treated with SBRT were enrolled. Patients underwent SBRT with endoscopic fiducial seed guidance, with either concurrent chemotherapy or dose-escalated radiotherapy alone. Fractionation regimens ranged from 3 to 5 fractions. RESULTS: With a median follow up of 8 months (range 8-51), the median overall survival was 8 months. The local control in those alive at 1 year was 75%. Five patients had Grade 3 toxicity and 5 had moderate (Grade 2) toxicity, with the remaining patients having mild or no toxicity. There were no Grade 4 or greater toxicities. CONCLUSION: SBRT potentially bypasses the dose limitations of adjacent organs compared with conventional radiotherapy, allowing for improved local control and shorter treatment times. The additional benefit of manageable toxicities makes this an appealing therapy for patients with unresectable pancreatic cancer.
Jin et al. (Wed,) studied this question.