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Stereotactic body radiotherapy in the treatment of Pancreatic Adenocarcinoma in elderly patients

Kim, CH and Ling, DC and Wegner, RE and Flickinger, JC and Heron, DE and Zeh, H and Moser, AJ and Burton, SA (2013) Stereotactic body radiotherapy in the treatment of Pancreatic Adenocarcinoma in elderly patients. Radiation Oncology, 8 (1).

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Abstract

Background: Treatment of pancreatic adenocarcinoma in the elderly is often complicated by comorbidities that preclude surgery, chemotherapy and/or conventional external beam radiation therapy (EBRT). Stereotactic body radiotherapy (SBRT) has thus garnered interest in this setting.Methods: A retrospective review of 26 patients of age ≥ 80 with pancreatic adenocarcinoma treated with definitive SBRT+/-chemotherapy from 2007-2011 was performed. Twenty-seven percent of patients were stage I, 38% were stage II, 27% were stage III and 8% were stage IV. Patients most commonly received 24 Gy/1 fraction or 30-36 Gy/3 fractions. Kaplan-Meier was used to estimate overall survival (OS), local control (LC), cause specific survival (CSS) and freedom-from-metastatic disease (FFMD).Results: The median age was 86 (range 80-91), and median follow-up was 11.6 months (3.5-24.6). The median planning target volume was 21.48 cm3 (6.1-85.09). Median OS was 7.6 months with 6/12 month OS rates of 65.4%/34.6%, respectively. Median LC was 11.5 months, 6-month and 12-month actuarial LC rates were 60.1% and 41.2%, respectively. There were no independent predictors for LC, but there was a trend for improved LC with prescription dose greater than 20 Gy (p = 0.063). Median CSS was 6.3 months, and 6-month and 12-month actuarial CSS were 53.8% and 23.1%, respectively. Median FFMD was 8.4 months, and 6-month and 12-month actuarial rates were 62.0% and 41.4%, respectively. Nine patients (47%) had local failures, 11 (58%) had distant metastasis, and 7 (37%) had both. There were no acute or late grade 3+ toxicities.Conclusions: Definitive SBRT is feasible, safe and effective in elderly patients who have unresectable disease, have comorbidities precluding surgery or decline surgery. © 2013 Kim et al.; licensee BioMed Central Ltd.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Kim, CH
Ling, DC
Wegner, RE
Flickinger, JCjflickin@pitt.eduJFLICKIN
Heron, DEdeh5@pitt.eduDEH5
Zeh, Hhjz1@pitt.eduHJZ1
Moser, AJ
Burton, SA
Centers: Other Centers, Institutes, or Units > Pittsburgh Cancer Institute
Date: 16 October 2013
Date Type: Publication
Journal or Publication Title: Radiation Oncology
Volume: 8
Number: 1
DOI or Unique Handle: 10.1186/1748-717x-8-240
Schools and Programs: School of Medicine > Radiation Oncology
School of Medicine > Surgery
Refereed: Yes
Date Deposited: 02 Dec 2016 16:09
Last Modified: 21 Jan 2019 15:55
URI: http://d-scholarship.pitt.edu/id/eprint/29669

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