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. 2018 Sep;36(3):200-209.
doi: 10.3857/roj.2018.00073. Epub 2018 Sep 30.

Effectiveness and feasibility of concurrent chemoradiotherapy using simultaneous integrated boost-intensity modulated radiotherapy with and without induction chemotherapy for locally advanced pancreatic cancer

Eun Sang Oh  1 , Tae Hyun Kim  1 , Sang Myung Woo  2 , Woo Jin Lee  2 , Ju Hee Lee  2 , Sang Hee Youn  1 , Sung Sik Han  2 , Sang Jae Park  2 , Dae Yong Kim  1
Affiliations

Effectiveness and feasibility of concurrent chemoradiotherapy using simultaneous integrated boost-intensity modulated radiotherapy with and without induction chemotherapy for locally advanced pancreatic cancer

Eun Sang Oh et al. Radiat Oncol J. 2018 Sep.

Abstract

Purpose: To evaluate the effectiveness and feasibility of chemoradiotherapy (CRT) using simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in locally advanced pancreatic cancer (LAPC) patients.

Materials and methods: Between January 2011 and May 2015, 47 LAPC patients received CRT using SIB-IMRT. Prior to SIBIMRT, 37 patients (78.7%) received induction chemotherapy (IC-CRT group) and remaining 10 patients (21.3%) did not received induction chemotherapy (CRT group). During SIB-IMRT, all patients received concomitant chemotherapy, with gemcitabine (n = 37) and capecitabine (n = 10).

Results: At the time of analysis, 45 patients had died and 2 patients remained alive and the median follow-up time was 14.2 months (range, 3.3 to 51.4 months). For all patients, the median times of local progression-free survival (LPFS), progression-free survival (PFS), and overall survival (OS) were 18.1, 10.3, and 14.2 months, respectively. The median time of LPFS between IC-CRT and CRT groups was similar (18.1 months vs. 18.3 months, p = 0.711). IC-CRT group had a higher trend in PFS (10.9 months vs. 4.1 months, p = 0.054) and had significantly higher OS (15.4 months vs. 9.5 months, p = 0.007) than CRT group. In multivariate analysis, the use of induction chemotherapy and tumor response were significant factors associated with OS (p < 0.05, each). During SIBIMRT, toxicity of grade ≥3 was observed in 7 patients (14.9%) in all patients.

Conclusion: CRT using SIB-IMRT is feasible and promising in LAPC patients.

Keywords: Intensity-modulated radiotherapy; Pancreas neoplasms; Radiotherapy; Survival.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Patterns of failure in all patients (A), induction chemotherapy followed by chemoradiotherapy (IC-CRT) group (B), and CRT without induction chemotherapy (CRT) group (C).
Fig. 2.
Fig. 2.
(A) Local progression-free survival (LPFS), (B) relapse-free survival (RFS), and (C) overall survival (OS) curves in all patients according to treatment groups. (D) LPFS, (E) RFS, and (F) OS in patients without distant metastasis within 3 months after treatment according to treatment groups. IC-CRT, induction chemotherapy followed by chemoradiotherapy; CRT, chemoradiotherapy without induction chemotherapy; CI, confidence interval. a)Log rank test.
See this image and copyright information in PMC

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