Intensity modulated radiotherapy as neoadjuvant chemoradiation for the treatment of patients with locally advanced pancreatic cancer: Outcome analysis and comparison with a 3D-treated patient cohort

Combs SE, Habermehl D, Kessel K, Bergmann F, Werner J, Brecht I, Schirmacher P, Jaeger D, Buechler MW, Debus J (2013)

Publication Type: Journal article

Publication year: 2013

Journal

Strahlentherapie und Onkologie Urban & Vogel

Book Volume: 189

Pages Range: 738-744

Journal Issue: 9

DOI: 10.1007/s00066-013-0391-5

Abstract

Background: To evaluate outcome after intensity modulated radiotherapy (IMRT) compared to 3D conformal radiotherapy (3D-RT) as neoadjuvant treatment in patients with locally advanced pancreatic cancer (LAPC). Materials and methods: In total, 57 patients with LAPC were treated with IMRT and chemotherapy. A median total dose of 45 Gy to the PTV-baseplan and 54 Gy to the PTV-boost in single doses of 1.8 Gy for the PTV-baseplan and median single doses of 2.2 Gy in the PTV-boost were applied. Outcomes were evaluated and compared to a large cohort of patients treated with 3D-RT. Results: Overall treatment was well tolerated in all patients and IMRT could be completed without interruptions. Median overall survival was 11 months (range 5-37.5 months). Actuarial overall survival at 12 and 24 months was 36 % and 8 %, respectively. A significant impact on overall survival could only be observed for a decrease in CA 19-9 during treatment, patients with less pre-treatment CA 19-9 than the median, as well as weight loss during treatment. Local progression-free survival was 79 % after 6 months, 39 % after 12 months, and 13 % after 24 months. No factors significantly influencing local progression-free survival could be identified. There was no difference in overall and progression-free survival between 3D-RT and IMRT. Secondary resectability was similar in both groups (26 % vs. 28 %). Toxicity was comparable and consisted mainly of hematological toxicity due to chemotherapy. Conclusion: IMRT leads to a comparable outcome compared to 3D-RT in patients with LAPC. In the future, the improved dose distribution, as well as advances in image-guided radiotherapy (IGRT) techniques, may improve the use of IMRT in local dose escalation strategies to potentially improve outcome. © 2013 Springer Heidelberg Berlin.

Involved external institutions

Universitätsklinikum Heidelberg DE Germany (DE) Deutsches Krebsforschungszentrum (DKFZ) DE Germany (DE)

How to cite

APA:

Combs, S.E., Habermehl, D., Kessel, K., Bergmann, F., Werner, J., Brecht, I.,... Debus, J. (2013). Intensity modulated radiotherapy as neoadjuvant chemoradiation for the treatment of patients with locally advanced pancreatic cancer: Outcome analysis and comparison with a 3D-treated patient cohort. Strahlentherapie und Onkologie, 189(9), 738-744. https://dx.doi.org/10.1007/s00066-013-0391-5

MLA:

Combs, S. E., et al. "Intensity modulated radiotherapy as neoadjuvant chemoradiation for the treatment of patients with locally advanced pancreatic cancer: Outcome analysis and comparison with a 3D-treated patient cohort." Strahlentherapie und Onkologie 189.9 (2013): 738-744.

BibTeX: Download