Dose escalation in locally advanced pancreatic cancer patients receiving chemoradiotherapy

Seung Yeun Chung, Jee Suk Chang, Byung Min Lee, Kyung Hwan Kim, Kyong Joo Lee, Jinsil Seong

Research output: Contribution to journalArticle

14 Citations (Scopus)

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 languageEnglish
Pages (from-to)438-445
Number of pages8
JournalRadiotherapy and Oncology
Volume123
Issue number3
DOIs
Publication statusPublished - 2017 Jun

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Chemoradiotherapy
Pancreatic Neoplasms
Disease-Free Survival
Survival
Propensity Score
Radiotherapy
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Chung, Seung Yeun ; Chang, Jee Suk ; Lee, Byung Min ; Kim, Kyung Hwan ; Lee, Kyong Joo ; Seong, Jinsil. / Dose escalation in locally advanced pancreatic cancer patients receiving chemoradiotherapy. In: Radiotherapy and Oncology. 2017 ; Vol. 123, No. 3. pp. 438-445.
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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.",
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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 journalArticle

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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

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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.

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