Abstract
Purpose To investigate whether radiotherapy (RT) dose escalation would improve treatment outcomes without increasing severe toxicity in locally advanced pancreatic cancer patients. Methods From 2005 to 2015, 497 locally advanced pancreatic cancer patients who received neoadjuvant or definitive chemoradiotherapy (CCRT) were included. Patients were divided according to the total dose (TD). Overall survival (OS), progression-free survival (PFS), local failure-free rate (LFFR), distant failure-free rate (DFFR), and toxicity rates were compared between <61 Gy (n = 345) and ≥61 Gy groups (n = 152). Additionally, propensity score matching was performed. Results At a median follow-up of 19.3 months (range, 4.8–128.5 months), the 1-year OS, PFS, LFFR, and DFFR were significantly higher in the ≥61 Gy group. After multivariate analysis, a TD of ≥61 Gy remained a significant favorable factor for OS (p = 0.019), PFS (p = 0.001), LFFR (p = 0.004), and DFFR (p = 0.008). After propensity score matching, the ≥61 Gy group still showed higher OS, PFS, and LFFR, but not DFFR (p = 0.205). The acute and late toxicity rates showed no significant difference between the two groups. Conclusion Patients who received a higher RT dose showed not only improved PFS and LFFR, but also improved OS without an increase in severe toxicity. Dose-escalated CCRT can be a favorable treatment option in locally advanced pancreatic cancer patients.
| Original language | English |
|---|---|
| Pages (from-to) | 438-445 |
| Number of pages | 8 |
| Journal | Radiotherapy and Oncology |
| Volume | 123 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2017 Jun |
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All Science Journal Classification (ASJC) codes
- Hematology
- Oncology
- Radiology Nuclear Medicine and imaging
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Dose escalation in locally advanced pancreatic cancer patients receiving chemoradiotherapy. / Chung, Seung Yeun; Chang, Jee Suk; Lee, Byung Min; Kim, Kyung Hwan; Lee, Kyong Joo; Seong, Jinsil.
In: Radiotherapy and Oncology, Vol. 123, No. 3, 06.2017, p. 438-445.Research output: Contribution to journal › Article
TY - JOUR
T1 - Dose escalation in locally advanced pancreatic cancer patients receiving chemoradiotherapy
AU - Chung, Seung Yeun
AU - Chang, Jee Suk
AU - Lee, Byung Min
AU - Kim, Kyung Hwan
AU - Lee, Kyong Joo
AU - Seong, Jinsil
PY - 2017/6
Y1 - 2017/6
N2 - Purpose To investigate whether radiotherapy (RT) dose escalation would improve treatment outcomes without increasing severe toxicity in locally advanced pancreatic cancer patients. Methods From 2005 to 2015, 497 locally advanced pancreatic cancer patients who received neoadjuvant or definitive chemoradiotherapy (CCRT) were included. Patients were divided according to the total dose (TD). Overall survival (OS), progression-free survival (PFS), local failure-free rate (LFFR), distant failure-free rate (DFFR), and toxicity rates were compared between <61 Gy (n = 345) and ≥61 Gy groups (n = 152). Additionally, propensity score matching was performed. Results At a median follow-up of 19.3 months (range, 4.8–128.5 months), the 1-year OS, PFS, LFFR, and DFFR were significantly higher in the ≥61 Gy group. After multivariate analysis, a TD of ≥61 Gy remained a significant favorable factor for OS (p = 0.019), PFS (p = 0.001), LFFR (p = 0.004), and DFFR (p = 0.008). After propensity score matching, the ≥61 Gy group still showed higher OS, PFS, and LFFR, but not DFFR (p = 0.205). The acute and late toxicity rates showed no significant difference between the two groups. Conclusion Patients who received a higher RT dose showed not only improved PFS and LFFR, but also improved OS without an increase in severe toxicity. Dose-escalated CCRT can be a favorable treatment option in locally advanced pancreatic cancer patients.
AB - Purpose To investigate whether radiotherapy (RT) dose escalation would improve treatment outcomes without increasing severe toxicity in locally advanced pancreatic cancer patients. Methods From 2005 to 2015, 497 locally advanced pancreatic cancer patients who received neoadjuvant or definitive chemoradiotherapy (CCRT) were included. Patients were divided according to the total dose (TD). Overall survival (OS), progression-free survival (PFS), local failure-free rate (LFFR), distant failure-free rate (DFFR), and toxicity rates were compared between <61 Gy (n = 345) and ≥61 Gy groups (n = 152). Additionally, propensity score matching was performed. Results At a median follow-up of 19.3 months (range, 4.8–128.5 months), the 1-year OS, PFS, LFFR, and DFFR were significantly higher in the ≥61 Gy group. After multivariate analysis, a TD of ≥61 Gy remained a significant favorable factor for OS (p = 0.019), PFS (p = 0.001), LFFR (p = 0.004), and DFFR (p = 0.008). After propensity score matching, the ≥61 Gy group still showed higher OS, PFS, and LFFR, but not DFFR (p = 0.205). The acute and late toxicity rates showed no significant difference between the two groups. Conclusion Patients who received a higher RT dose showed not only improved PFS and LFFR, but also improved OS without an increase in severe toxicity. Dose-escalated CCRT can be a favorable treatment option in locally advanced pancreatic cancer patients.
UR - http://www.scopus.com/inward/record.url?scp=85018274130&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018274130&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2017.04.010
DO - 10.1016/j.radonc.2017.04.010
M3 - Article
C2 - 28464997
AN - SCOPUS:85018274130
VL - 123
SP - 438
EP - 445
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
IS - 3
ER -