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Published in: Strahlentherapie und Onkologie 7/2018

Open Access 01-07-2018 | Original Article

Nonmetastatic pancreatic cancer

Improved survival with chemoradiotherapy > 40 Gy after systemic treatment

Authors: Sebastian Bachmayer, M.D., Gerd Fastner, M.D., Andrea Vaszi, M.D., Wolfgang Iglseder, M.D., Peter Kopp, Ph.D., Josef Holzinger, M.D., Adam Dinnewitzer, M.D., Gabriel Rinnerthaler, M.D., Simon Peter Gampenrieder, M.D., Klaus Emmanuel, M.D., Richard Greil, M.D., Felix Sedlmayer, M.D., Franz Zehentmayr, M.D., M.Sc.

Published in: Strahlentherapie und Onkologie | Issue 7/2018

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Abstract

Purpose

The role of radiotherapy (RT) for nonmetastatic pancreatic cancer is still a matter of debate since randomized control trials have shown inconsistent results. The current retrospective single-institution study includes both resected and unresected patients with nonmetastasized pancreatic cancer. The aim is to analyze overall survival (OS) after irradiation combined with induction chemotherapy.

Patients and methods

Of the 73 patients with nonmetastatic pancreatic cancer eligible for the present analysis, 42 (58%) patients had adjuvant chemoradiotherapy (CRT), while 31 (42%) received CRT as primary treatment. In all, 65 (89%) had chemotherapy at any time before, during, or after RT, and 39 (53%) received concomitant CRT. The median total dose was 50 Gy (range 12–77 Gy), while 61 (84%) patients received >40 Gy.

Results

With a median follow-up of 22 months (range 1.2–179.8 months), 14 (19%) are still alive and 59 (81%) of the patients have died, whereby 51 (70%) were cancer-related deaths. Median OS and the 2‑year survival rate were 22.9 months (1.2–179.8 months) and 44%, respectively. In addition, 61 (84%) patients treated with >40 Gy had a survival advantage (median OS 23.7 vs. 17.3 months, p = 0.026), as had patients with 4 months minimum of systemic treatment (median OS 27.5 vs. 14.3 months, p = 0.0004).

Conclusion

CRT with total doses >40 Gy after induction chemotherapy leads to improved OS in patients with nonmetastatic pancreatic cancer.
Appendix
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Metadata
Title
Nonmetastatic pancreatic cancer
Improved survival with chemoradiotherapy > 40 Gy after systemic treatment
Authors
Sebastian Bachmayer, M.D.
Gerd Fastner, M.D.
Andrea Vaszi, M.D.
Wolfgang Iglseder, M.D.
Peter Kopp, Ph.D.
Josef Holzinger, M.D.
Adam Dinnewitzer, M.D.
Gabriel Rinnerthaler, M.D.
Simon Peter Gampenrieder, M.D.
Klaus Emmanuel, M.D.
Richard Greil, M.D.
Felix Sedlmayer, M.D.
Franz Zehentmayr, M.D., M.Sc.
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 7/2018
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-018-1281-7

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