Rajagopalan, MS and Heron, DE and Wegner, RE and Zeh, HJ and Bahary, N and Krasinskas, AM and Lembersky, B and Brand, R and Moser, AJ and Quinn, AE and Burton, SA
(2013)
Pathologic response with neoadjuvant chemotherapy and stereotactic body radiotherapy for borderline resectable and locally-advanced pancreatic cancer.
Radiation Oncology, 8 (1).
Abstract
Background: Neoadjuvant stereotactic body radiotherapy (SBRT) has potential applicability in the management of borderline resectable and locally-advanced pancreatic adenocarcinoma. In this series, we report the pathologic outcomes in the subset of patients who underwent surgery after neoadjuvant SBRT. Methods: Patients with borderline resectable or locally-advanced pancreatic adenocarcinoma who were treated with SBRT followed by resection were included. Chemotherapy was to the discretion of the medical oncologist and preceded SBRT for most patients. Results: Twelve patients met inclusion criteria. Most (92%) received neoadjuvant chemotherapy, and gemcitabine/capecitabine was most frequently utilized (n = 7). Most were treated with fractionated SBRT to 36 Gy/3 fractions (n = 7) and the remainder with single fraction to 24 Gy (n = 5). No grade 3+ acute toxicities attributable to SBRT were found. Two patients developed post-surgical vascular complications and one died secondary to this. The mean time to surgery after SBRT was 3.3 months. An R0 resection was performed in 92% of patients (n = 11/12). In 25% (n = 3/12) of patients, a complete pathologic response was achieved, and an additional 16.7% (n = 2/12) demonstrated <10% viable tumor cells. Kaplan-Meier estimated median progression free survival is 27.4 months. Overall survival is 92%, 64% and 51% at 1-, 2-, and 3-years. Conclusions: This study reports the pathologic response in patients treated with neoadjuvant chemotherapy and SBRT for borderline resectable and locally-advanced pancreatic cancer. In our experience, 92% achieved an R0 resection and 41.7% of patients demonstrated either complete or extensive pathologic response to treatment. The results of a phase II study of this novel approach will be forthcoming. © 2013 Rajagopalan et al.; licensee BioMed Central Ltd.
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| Item Type: |
Article
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| Status: |
Published |
| Creators/Authors: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Rajagopalan, MS | | | | | Heron, DE | deh5@pitt.edu | DEH5 | | | Wegner, RE | | | | | Zeh, HJ | hjz1@pitt.edu | HJZ1 | | | Bahary, N | bahary@pitt.edu | BAHARY | | | Krasinskas, AM | | | | | Lembersky, B | | | | | Brand, R | reb53@pitt.edu | REB53 | | | Moser, AJ | | | | | Quinn, AE | | | | | Burton, SA | | | |
|
| Centers: |
Other Centers, Institutes, Offices, or Units > Pittsburgh Cancer Institute |
| Date: |
31 October 2013 |
| Date Type: |
Publication |
| Journal or Publication Title: |
Radiation Oncology |
| Volume: |
8 |
| Number: |
1 |
| DOI or Unique Handle: |
10.1186/1748-717x-8-254 |
| Schools and Programs: |
School of Medicine > Medicine
School of Medicine > Pathology
School of Medicine > Radiation Oncology
School of Medicine > Surgery |
| Refereed: |
Yes |
| Date Deposited: |
02 Dec 2016 16:10 |
| Last Modified: |
02 Feb 2019 15:58 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/29662 |
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