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Multicenter Study
. 2015 Oct;117(1):159-64.
doi: 10.1016/j.radonc.2015.07.018. Epub 2015 Jul 30.

Radiosensitivity index predicts for survival with adjuvant radiation in resectable pancreatic cancer

Tobin Strom  1 , Sarah E Hoffe  1 , William Fulp  2 , Jessica Frakes  1 , Domenico Coppola  3 , Gregory M Springett  3 , Mokenge P Malafa  3 , Cynthia L Harris  3 , Steven A Eschrich  2 , Javier F Torres-Roca  4 , Ravi Shridhar  5
Affiliations
Multicenter Study

Radiosensitivity index predicts for survival with adjuvant radiation in resectable pancreatic cancer

Tobin Strom et al. Radiother Oncol. 2015 Oct.

Abstract

Background and purpose: Adjuvant radiation therapy for resectable pancreatic cancer remains controversial. Sub-populations of radiosensitive tumors might exist given the genetic heterogeneity of pancreatic cancers. We evaluated whether RSI is predictive of survival in pancreatic cancer treated with radiation.

Materials and methods: We identified 73 genomically-profiled pancreas cancer patients treated with upfront surgery between 2000 and 2011 (48 radiation, 25 no radiation). Briefly, RSI score is derived from the expression of 10 specific genes and a linear regression algorithm modeled on SF2 of 48 cancer cells. The primary endpoint was to assess the association of RSI with overall survival.

Results: Median follow-up was 67months for surviving patients. On multivariate analysis, patients with radioresistant tumors had a trend toward worse survival (Hazard ratio [HR] 2.1 [95% CI 1.0-4.3], p=0.054). Among high-risk, irradiated patients (positive margins, positive lymph nodes, or a post-operative CA19-9 >90; n=31), radiosensitive patients had significantly improved survival compared with radioresistant patients (median 31.2 vs. 13.2months; HR 0.42 [0.19, 0.94], p=0.04). Among irradiated patients (n=48), low-risk patients lived longer than both high-risk patients with radiosensitive tumors and radioresistant tumors (HR 2.7 [1.0, 7.2], p=0.04 and HR 6.3 [2.3, 17.0], p<0.001, respectively).

Conclusions: Integrating RSI with standard high-risk variables has the potential to refine the classification of high-risk resected pancreatic cancer patients treated with radiation therapy.

Trial registration: ClinicalTrials.gov NCT01754623.

Keywords: Cancer; Pancreas; Radiation; Radiosensitivity; Surgery; Survival.

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Conflict of interest statement

Conflicts of interest

Figures

Fig. 1.
Fig. 1.
Flow chart demonstrating inclusion criteria for 73 evaluable patients who underwent upfront resection for pancreatic carcinoma with microarray and RSI data available.
Fig. 2.
Fig. 2.
Kaplan–Meier overall survival plot (a) of all patients (n = 73) assessed by low risk (negative margins, negative lymph nodes, and a post-operative CA19–9 ≤90) vs. high-risk (positive margins, positive lymph nodes, or a post-operative CA19–9 >90, p = 0.002) and (b) of patients treated with radiation therapy (n = 48) by (b) radiosensitivity index (RSI)-low (radiosensitive) vs. RSI-high (radioresistant, p = 0.45).
Fig. 3.
Fig. 3.
Kaplan–Meier overall survival plot of patients treated with radiation therapy (n = 48) assessed by clinicopathologic low-risk (negative margins, negative lymph nodes, and a post-operative CA19–9 ≤90) vs. high-risk + radiosensitivity index (RSI)-low (radiosensitive) vs. high-risk + RSI-high (radioresistant, p < 0.001).
See this image and copyright information in PMC

References

    1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013;63:11–30. - PubMed
    1. Li D, Xie K, Wolff R, Abbruzzese JL. Pancreatic cancer. Lancet 2004;363:1049–57. - PubMed
    1. Iacobuzio-Donahue CA, Fu B, Yachida S, Luo M, Abe H, Henderson CM, et al. DPC4 gene status of the primary carcinoma correlates with patterns of failure in patients with pancreatic cancer. J Clin Oncol 2009;27:1806–13. - PMC - PubMed
    1. Neoptolemos JP, Stocken DD, Friess H, Bassi C, Dunn JA, Hickey H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. New Engl J Med 2004;350:1200–10. - PubMed
    1. Smeenk HG, van Eijck CH, Hop WC, Erdmann J, Tran KC, Debois M, et al. Long-term survival and metastatic pattern of pancreatic and periampullary cancer after adjuvant chemoradiation or observation: long-term results of EORTC trial 40891. Ann Surg 2007;246:734–40. - PubMed

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