دورية أكاديمية
Ablative Radiation Therapy in Oligometastatic Pancreatic Cancer to Delay Polyprogression, Limit Chemotherapy, and Improve Outcomes.
| العنوان: | Ablative Radiation Therapy in Oligometastatic Pancreatic Cancer to Delay Polyprogression, Limit Chemotherapy, and Improve Outcomes. |
|---|---|
| المؤلفون: | Elamir AM; Department of Radiation Oncology, the University of Texas Southwestern Medical Center, Dallas, Texas., Karalis JD; Department of Surgery, the University of Texas Southwestern Medical Center, Dallas, Texas., Sanford NN; Department of Radiation Oncology, the University of Texas Southwestern Medical Center, Dallas, Texas., Polanco PM; Department of Surgery, the University of Texas Southwestern Medical Center, Dallas, Texas., Folkert MR; Department of Radiation Medicine, Northwell Health, New Hyde Park, New York., Porembka MR; Department of Surgery, the University of Texas Southwestern Medical Center, Dallas, Texas., Kazmi SA; Department of Internal Medicine, the University of Texas Southwestern Medical Center, Dallas, Texas., Maddipati R; Department of Internal Medicine, the University of Texas Southwestern Medical Center, Dallas, Texas., Zeh HJ; Department of Surgery, the University of Texas Southwestern Medical Center, Dallas, Texas., Timmerman RD; Department of Radiation Oncology, the University of Texas Southwestern Medical Center, Dallas, Texas., Zhang S; Department of Population and Data Sciences, the University of Texas Southwestern Medical Center, Dallas, Texas., Ligorio M; Department of Surgery, the University of Texas Southwestern Medical Center, Dallas, Texas., Beg MS; Department of Internal Medicine, the University of Texas Southwestern Medical Center, Dallas, Texas., Aguilera TA; Department of Radiation Oncology, the University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: todd.aguilera@utsouthwestern.edu. |
| المصدر: | International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2022 Nov 15; Vol. 114 (4), pp. 792-802. Date of Electronic Publication: 2022 Jul 24. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier, Inc Country of Publication: United States NLM ID: 7603616 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-355X (Electronic) Linking ISSN: 03603016 NLM ISO Abbreviation: Int J Radiat Oncol Biol Phys Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, NY : Elsevier, Inc Original Publication: Elmsford, N. Y., Pergamon Press. |
| مواضيع طبية MeSH: | Adenocarcinoma* , Pancreatic Neoplasms*/radiotherapy , Radiosurgery*/methods, CA-19-9 Antigen ; Humans ; Pancreatic Neoplasms |
| مستخلص: | Purpose: The oligometastatic state is observed in patients across many malignancies, with increased recognition regarding improved outcomes after local therapies. However, there is limited data specifically regarding pancreatic ductal adenocarcinoma. We hypothesized that an oligometastatic pancreatic ductal adenocarcinoma (OPanc) phenotype would benefit from stereotactic ablative radiation therapy (SABR) to all active metastatic sites. Here, we report our institutional experience of SABR-treated OPanc to evaluate the feasibility of the approach. Methods and Materials: A retrospective review of patients with synchronous or metachronous OPanc (1 to 5 metastases) who received SABR to all active metastatic sites was performed. We identified a comparable group of patients with similar metastatic burden, range of CA19-9 levels, and no progression for at least 5 months who did not receive SABR. We compared overall survival as the primary outcome, and polyprogression-free survival and time off chemotherapy as the secondary exploratory assessments. A third group presenting with stage IV pancreatic ductal adenocarcinoma and more than 5 distant lesions (polymetastatic) was identified to help define expected outcomes after polyprogression. Results: Our study included 20 patients with OPanc receiving SABR and 21 who did not. SABR was delivered to 38 metastatic tumors. Out of the 20 SABR-treated OPanc patients, 17 (85%) had 6 or more months of time off chemotherapy, compared with 7 patients (33.3%) among the chemotherapy-treated group. Median polyprogression-free survival was 40 and 14 months (hazard ratio = 0.2; 95% confidence interval, 0.07-0.54; P = .0009), and overall survival was 42 and 18 months (hazard ratio = 0.21; 95% confidence interval, 0.08-0.53; P = .0003), for SABR- and chemotherapy-treated cohorts, respectively. Conclusions: Management of OPanc with SABR as local regional therapy could improve outcomes in a selected population and warrants prospective evaluation. (Copyright © 2022 Elsevier Inc. All rights reserved.) |
| المشرفين على المادة: | 0 (CA-19-9 Antigen) |
| تواريخ الأحداث: | Date Created: 20220727 Date Completed: 20221018 Latest Revision: 20231213 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.ijrobp.2022.07.019 |
| PMID: | 35896145 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-355X |
|---|---|
| DOI: | 10.1016/j.ijrobp.2022.07.019 |