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Session Item

Clinical track: Upper GI (oesophagus, stomach, pancreas, liver)
Poster
Clinical
00:00 - 00:00
SBRT vs conventionally fractionated radio-chemotherapy for pancreatic cancer: a case-control study
PO-1042

Abstract

SBRT vs conventionally fractionated radio-chemotherapy for pancreatic cancer: a case-control study
Authors: Arcelli|, Alessandra(1)*[alearceese@hotmail.it];Bertini|, Federica(1);Morganti|, Alessio Giuseppe(1);Guido|, Alessandra(1);Deodato|, Francesco(2);Cilla|, Savino(3);Scotti|, Valerio(4);Rosetto|, Maria Elena(5);Djan|, Igor(6);Parisi|, Salvatore(7);Cammelli|, Silvia(1);Mattiucci|, Gian Carlo(8);Fiore|, Michele(9);Bonomo|, Pierluigi(10);Bacigalupo|, Alessandra(11);Niespolo|, Rita Marina(12);Gabriele|, Paolo(13);Simoni|, Nicola(14);Mazzarotto|, Renzo(14);Macchia|, Gabriella(2);
(1)Radiation Oncology Center- University of Bologna, Department of Experimental- Diagnostic and Specialty Medicine - DIMES, Bologna, Italy;(2)Radiotherapy Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Campobasso, Italy;(3)Medical Physic Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Campobasso, Italy;(4)Casa di Cura San Rossore, Casa di Cura San Rossore, Pisa, Italy;(5)Radiotherapy Unit, Ospedale Belcolle, Viterbo, Italy;(6)Institute of Oncology Vojvodina-Sremska Kamenica, Medical Faculty- University of Novi Sad, Novi Sad, Serbia;(7)Radiotherapy Unit, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo- Foggia, Italy;(8)Policlinico Universitario "A. Gemelli", Department of Radiotherapy- Catholic University of Sacred Heart, Rome, Italy;(9)University Campus Biomedico, Department of Radiotherapy, Rome, Italy;(10)Azienda Ospedaliero-Universitaria Careggi, Department of Radiotherapy- University of Florence, Florence, Italy;(11)IRCCS AOU San Martino, Department of Radiotherapy, Genova, Italy;(12)Azienda Ospedaliera San Gerardo, Radiotherapy Unit, Monza, Italy;(13)Fondazione del Piemonte per l'Oncologia- IRCCS Candiolo, Department of Radiotherapy, Turin, Italy;(14)University Hospital, Radiotherapy Unit, Verona, Italy;
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Purpose or Objective

Conventionally fractionated external beam radiotherapy + chemotherapy (RCT) or chemotherapy (CHT) alone are both well-established options for locally advanced pancreatic cancer (LAPC), while Stereotactic body radiotherapy (SBRT) is an emerging option for LAPC. Aim of this multicentric case-control study is to compare two cohorts of LAPC patients treated with RCT +/- CHT or SBRT +/- CHT in terms of overall survival (OS), local control (LC), distant metastases-free survival (DMFS), disease-free survival (DFS), and toxicity.

Material and Methods

Eighty patients were included. Patients in the two cohorts were matched according to: age </≥ 65years; tumor diameter < 3.0 cm, ≥ 3.0 cm and ≤ 3.9 cm, > 3.9 cm; cT; cN; neoadjuvant or adjuvant CHT. Median prescribed total dose was 30.0 Gy (range: 18.0-37.5) and 54.0 Gy (18.0-63.0) for SBRT and RCT cohort, respectively. Toxicity was evaluated by CTCAE v4.0 scale. Survival curves were assessed by Kaplan-Meier method. For hypothesis testing, an equivalence and a non-inferiority test was calculated.

Results

At univariate analysis no statistically, significant differences based on the matching criteria and acute and late toxicities, were recorded. No statistically significant differences were recorded even in terms of OS, DFS, and DMFS between the two cohorts. Median, 1-, and 2-year LC were: 16.0 months, 53.1%, 40.5% and 22.0 months, 80.4%, 49.8% (p= 0.017), for RCT cohort and SBRT cohort, respectively. A statistically non inferiority significance in terms of OS between RCT and SBRT was recorded (95% CI: 2.24, p= 0.031).

Conclusion

Our analysis demonstrated that SBRT is comparable to RCT in terms of clinical outcomes and yet convenient for the patients due to its short duration. Therefore, our study seems to justify randomized studies to compare SBRT +/- CHT and RCT