Stereotactic Body Radiotherapy (SBRT) Reirradiation for Recurrent Pancreas Cancer

Nergiz Dagoglu, Mark Callery, James Moser, Jennifer Tseng, Tara Kent, Andrea Bullock, Rebecca Miksad, Joseph D Mancias, Anand Mahadevan, Nergiz Dagoglu, Mark Callery, James Moser, Jennifer Tseng, Tara Kent, Andrea Bullock, Rebecca Miksad, Joseph D Mancias, Anand Mahadevan

Abstract

Objectives: After adjuvant or definitive radiation for pancreas cancer, there are limited conventional treatment options for recurrent pancreas cancer. We explored the role of (Stereotactic Body Radiotherapy) SBRT for reirradiation of recurrent pancreas Cancer.

Methods: This is a retrospective study of patients reirradiated with SBRT for recurrent pancreas cancer. All patients were deemed unresectable and treated with systemic therapy. Fiducial gold markers were used. CT simulation was performed with oral and IV contrast and patients were treated with respiratory motion tracking in the Cyberknife(TM) system.

Results: 30 patients (17 men and 13 women) with a median age of 67 years were included in the study. The median target volume was 41.29cc. The median prescription dose was 25Gy (24-36Gy) in a median of 5 fractions prescribed to a mean 78% isodose line. The median overall survival was 14 months. The 1 and 2 year local control was 78%. The worst toxicity included 3/30(10%) Grade III acute toxicity for pain, bleeding and vomiting. There was 2/30 (7%) Grade III long-term bowel obstructions.

Conclusions: SBRT can be a useful and tolerable option for patients with recurrent pancreas cancer after prior radiation.

Keywords: Pancreatic Cancer; Reirradiation; SBRT (Stereotactic Body Radiotherapy).

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Representative Treatment Plan
Figure 2
Figure 2
Local Control (Top Panel) and Overall Survival (Bottom Panel)

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