Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Effectiveness and feasibility of concurrent chemoradiotherapy using simultaneous integrated boost-intensity modulated radiotherapy with and without induction chemotherapy for locally advanced pancreatic cancer

  • Oh, Eun Sang (Proton Therapy Center, National Cancer Center Research Institute and Hospital, National Cancer Institute) ;
  • Kim, Tae Hyun (Proton Therapy Center, National Cancer Center Research Institute and Hospital, National Cancer Institute) ;
  • Woo, Sang Myung (Center for Liver Cancer, National Cancer Center Research Institute and Hospital, National Cancer Institute) ;
  • Lee, Woo Jin (Center for Liver Cancer, National Cancer Center Research Institute and Hospital, National Cancer Institute) ;
  • Lee, Ju Hee (Center for Liver Cancer, National Cancer Center Research Institute and Hospital, National Cancer Institute) ;
  • Youn, Sang Hee (Proton Therapy Center, National Cancer Center Research Institute and Hospital, National Cancer Institute) ;
  • Han, Sung Sik (Center for Liver Cancer, National Cancer Center Research Institute and Hospital, National Cancer Institute) ;
  • Park, Sang Jae (Center for Liver Cancer, National Cancer Center Research Institute and Hospital, National Cancer Institute) ;
  • Kim, Dae Yong (Proton Therapy Center, National Cancer Center Research Institute and Hospital, National Cancer Institute)
  • Received : 2018.02.12
  • Accepted : 2018.07.23
  • Published : 2018.09.30
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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 SIB-IMRT, 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 SIB-IMRT, toxicity of grade ≥3 was observed in 7 patients (14.9%) in all patients. Conclusions: CRT using SIB-IMRT is feasible and promising in LAPC patients.

Keywords

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