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.1 Previous research has suggested that radiotherapy may be of little help in this setting.
The study retrospectively analyzed 514 patients from Europe and the United States 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 to the dose of radiation they received.
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, whereas 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. 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.”
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 benefited from a number of technologic 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, on a study of presurgical high-dose radiotherapy combined with chemotherapy to treat pancreatic cancer.
1. Cellini F, et al: Adjuvant chemoradiation in pancreatic cancer: Impact of radiotherapy dose on survival. ESTRO 36. Abstract OC-0426. Presented May 8, 2017.