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Dose escalation in locally advanced pancreatic cancer patients receiving chemoradiotherapy

Authors
 Seung Yeun Chung  ;  Jee Suk Chang  ;  Byung Min Lee  ;  Kyung Hwan Kim  ;  Kyong Joo Lee  ;  Jinsil Seong 
Citation
 RADIOTHERAPY AND ONCOLOGY, Vol.123(3) : 438-445, 2017 
Journal Title
 RADIOTHERAPY AND ONCOLOGY 
ISSN
 0167-8140 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Chemoradiotherapy* ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/therapy* ; Radiotherapy Dosage ; Retrospective Studies
Keywords
Chemoradiotherapy ; Dose escalation ; Pancreatic cancer
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 <61Gy (n=345) and ≥61Gy groups (n=152). Additionally, propensity score matching was performed. RESULTS: At a median follow-up of 19.3months (range, 4.8-128.5months), the 1-year OS, PFS, LFFR, and DFFR were significantly higher in the ≥61Gy group. After multivariate analysis, a TD of ≥61Gy 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 ≥61Gy 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.
Full Text
https://www.sciencedirect.com/science/article/pii/S0167814017301512
DOI
10.1016/j.radonc.2017.04.010
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Chang, Jee Suk Paul(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Chung, Seung Yeun(정승연) ORCID logo https://orcid.org/0000-0002-3877-6950
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160294
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