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ESTRO 2017: Study Suggests Role for Radiotherapy in Extending Survival in Patients With Early-Stage Pancreatic Cancer

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Key Points

  • Patients who received a dose less than 45 Gy had an average survival of 13 months, while patients with a dose in the range of 45 to less than 50 Gy had an average survival of 21 months.
  • A dose range of 50 to less than 55 Gy produced an average survival of 22 months; for the group with the highest doses of 55 Gy or more, average survival was 28 months.

Radiotherapy at a high enough dose may increase survival in early-stage pancreatic cancer, according to research presented at the European Society for Radiotherapy & Oncology (ESTRO) 36 Conference (Abstract OC-0426). Previous research has suggested that radiotherapy may be of little help to patients with pancreatic cancer, but new research indicates that it may have a role to play.

The study retrospectively analyzed 514 patients from Europe and the U.S. who were diagnosed with local, resectable pancreatic cancer. Following surgery, all the patients had been treated with chemoradiotherapy. Patients were followed for an average of 20 months. The researchers divided the patients up into four groups according the dose of radiation they received.

Findings

The results suggest that the higher the dose, the longer the survival of the patient. Patients who received a dose less than 45 Gy had an average survival of 13 months, while patients with a dose in the range of 45 to less than 50 Gy had an average survival of 21 months. For the next group with a dose range of 50 to less than 55 Gy, average survival was 22 months; and for the group with the highest doses of 55 Gy or more, average survival was 28 months.

The research was presented by Francesco Cellini, MD, radiation oncologist at the Fondazione Policlinico Universitario Agostino Gemelli and the Università Cattolica del Sacro Cuore, Rome, Italy. He told the conference, “Survival rates for pancreatic cancer remain stubbornly low, with most patients given months rather than years to live. Previous research has not shown a benefit for treating pancreatic cancer with radiotherapy, suggesting that these tumors are somehow resistant to radiation, but this study suggests the situation is more nuanced. We have found that the higher the dose, the longer the patient is likely to survive. This may indicate that the doses were simply not high enough in previous research.”

He continued, “The pattern of increasing survival in this study suggests that tumors of the pancreas are not resistant to radiation—they just need to be tackled with an adequate dose…Radiotherapy has benefitted from a number of technological improvements over recent years, and it is becoming easier to give higher doses that are targeted to the tumor area. This study suggests radiotherapy should be considered for patients with early-stage pancreatic cancer. It may also be worthwhile to investigate whether current radiotherapy techniques could also bring survival benefits to patients with more advanced tumors.”

Dr. Cellini is now working with colleagues under the supervision of Alessio Morganti, MD, (leader of the presented research) on a study using presurgical high-dose radiotherapy combined with chemotherapy to treat patients with pancreatic cancer. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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