Initial systemic chemotherapy ( 6 months ) with a combination regimen is recommended for most patients ( for some patients radiation therapy may be offered up front ) with Eastern Cooperative Oncology Group performance status 0 or 1 and a favorable comorbidity profile .
There is no clear evidence to support one regimen over another .
PURPOSE To provide evidence -based recommendations to oncologists and others for treatment of patients with locally advanced , unresectable pancreatic cancer .
The Role of Stereotactic Body Radiation Therapy for Pancreatic Cancer: A Single-Institution Experience
Background Stereotactic body radiation therapy ( SBRT ) is a promising option for patients with pancreatic cancer ( PCA ) ; however , limited data support its efficacy . This study review s our institutional experience of SBRT in the treatment of locally advanced ( LAPC ) and borderline resectable ( BRPC ) PCA . Methods Charts of all PCA patients receiving SBRT at our institution from 2010 to 2014 were review ed . Most patients received pre-SBRT chemotherapy . Primary endpoints included overall survival ( OS ) and local progression-free survival ( LPFS ) . Patients received a total dose of 25–33 Gy in five fractions . Results A total of 88 patients were included in the analysis , 74 with LAPC and 14 with BRPC . The median age at diagnosis was 67.2 years , and median follow-up from date of diagnosis for LAPC and BRPC patients was 14.5 and 10.3 months , respectively  . Median OS from date of diagnosis was 18.4 months ( LAPC , 18.4 mo ; BRPC , 14.4 mo ) and median PFS was 9.8 months ( 95 % CI 8.0–12.3 ) . Acute toxicity was minimal with only three patients ( 3.4 % ) experiencing acute grade ≥3 toxicity . Late grade ≥2 gastrointestinal toxicity was seen in five patients ( 5.7 % ) . Of the 19 patients ( 21.6 % ) who underwent surgery , 79 % were LAPC patients and 84 % had margin-negative resections . Conclusions Chemotherapy followed by SBRT in patients with LAPC and BRPC result ed in minimal acute and late toxicity . A large proportion of patients underwent surgical resection despite limited radiographic response to therapy . Further refinements in the integration of chemotherapy , SBRT , and surgery might offer additional advancements toward optimizing patient outcomes
Initial systemic chemotherapy ( 6 months ) with a combination regimen is recommended for most patients ( for some patients radiation therapy may be offered up front ) with Eastern Cooperative Oncology Group performance status 0 or 1 and a favorable comorbidity profile .
There is no clear evidence to support one regimen over another .
PURPOSE To provide evidence -based recommendations to oncologists and others for treatment of patients with locally advanced , unresectable pancreatic cancer .