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Association of survival with stereotactic body radiation therapy following induction chemotherapy for unresected locally advanced pancreatic cancer

Published online by Cambridge University Press:  14 April 2021

Sung Jun Ma ,
Lucas M. Serra ,
Austin J. Bartl ,
Hye Ri Han ,
Fatemeh Fekrmandi ,
Austin J. Iovoli ,
Kavitha M. Prezzano ,
Gregory M. Hermann ,
Han Yu  and
Anurag K. Singh Open the ORCID record for Anurag K. Singh [Opens in a new window]
Sung Jun Ma
Affiliation:
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Lucas M. Serra
Affiliation:
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
Austin J. Bartl
Affiliation:
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
Hye Ri Han
Affiliation:
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
Fatemeh Fekrmandi
Affiliation:
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Austin J. Iovoli
Affiliation:
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Kavitha M. Prezzano
Affiliation:
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Gregory M. Hermann
Affiliation:
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Han Yu
Affiliation:
Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Anurag K. Singh*
Affiliation:
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
*
Author for correspondence: Dr Anurag K. Singh, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Tel: 716 845 5715. Fax: 716 845 7616. E-mail: anurag.singh@roswellpark.org
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Abstract

Aim:

Induction chemotherapy (iC) followed by concurrent chemoradiation has been shown to improve overall survival (OS) for locally advanced pancreatic cancer (LAPC). However, the survival benefit of stereotactic body radiation therapy (SBRT) versus conventionally fractionated radiation therapy (CFRT) following iC remains unclear.

Materials and methods:

The National Cancer Database (NCDB) was queried for primary stage III, cT4N0-1M0 LAPC (2004–15). Kaplan–Meier analysis, Cox proportional hazards method and propensity score matching were used.

Results:

Among 872 patients, 738 patients underwent CFRT and 134 patients received SBRT. Median follow-up was 24·3 and 22·9 months for the CFRT and SBRT cohorts, respectively. The use of SBRT showed improved survival in both the multivariate analysis (hazards ratio 0·78, p = 0·025) and 120 propensity-matched pairs (median OS 18·1 versus 15·9 months, p = 0·004) compared to the CFRT.

Findings:

This NCDB analysis suggests survival benefit with the use of SBRT versus CFRT following iC for the LAPC.

Keywords

National Cancer DatabasepancreasSABRSBRT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 3 , September 2022 , pp. 403 - 410
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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