View in EDS

Addition of SBRT and Outcomes in Borderline Resectable Pancreatic Cancer Patients Having Suboptimal Response to Neoadjuvant Chemotherapy.

Saved in:
Bibliographic Details
Title: Addition of SBRT and Outcomes in Borderline Resectable Pancreatic Cancer Patients Having Suboptimal Response to Neoadjuvant Chemotherapy.
Authors: Engineer, R.1 (AUTHOR), Pathare, P.2 (AUTHOR), Bhandare, M.3 (AUTHOR), Krishnatry, R.1 (AUTHOR), Gudi, S.2 (AUTHOR), Ostwal, V.4 (AUTHOR), Ramaswamy, A.4 (AUTHOR), Shrikhande, S.3 (AUTHOR)
Source: International Journal of Radiation Oncology, Biology, Physics. 2024 Supplement, Vol. 120 Issue 2, pe437-e438. 2p.
Subjects: Neoadjuvant chemotherapy, Pancreatic cancer, Overall survival, Surgical complications, Cancer patients
Abstract: Role of SBRT in patients who do not respond to NACT is not yet well defined. We conducted this study to evaluate the impact of SBRT in borderline resectable pancreatic cancer patients with suboptimal response to NACT All consecutive patients staged as BRPC at our center from 2016 to 2020 were included. All received NACT with mFOLFIRINOX or NAB-PACLITAXEL (4-6 cycles) followed by surgical assessment. Patients with radiological partial response (PR) were surgically explored, those with poor response or stable disease not amenable to R0 resection received SBRT and additional chemotherapy followed by surgical assessment. SBRT consisted of 42 -45 Gy over 5 fractions in 10 days. A total of 151 patients with BRPC were registered. During NACT, 44(29%) patients either defaulted or progressed and 107 (69.9%) patients completed at least 4 cycles of NACT and response assessment CECT scan was done. Post NACT, 36(33.6%) patients with partial response were surgically explored, 22(73%) underwent R0 and 8 (24%) had R1 resection (Group 1, n = 30). Remaining 71(66.3%) patients had suboptimal response to NACT and were not feasible for R0 resection received additional SBRT and CT. Post SBRT 28(26.1%) patients were surgically explored and 17 (77%) underwent R0 resection whereas 5 (23%) had R1 resection (Group 2, n = 22). Remaining 43(40%) (Group 3, n = 43) patients continued to receive palliative chemotherapy. At median follow up of 18 months, Median overall survival (OS) and 2-year OS for the whole group (107 patients) was 18 (13-22) months and 37.1% respectively. Group 1 (Patients undergoing curative resection after NACT) had median OS of 26 (19-32) months and 2-year OS of 56 % while Group 2 (patients with addition of SBRT after NACT to achieve curative resection) had median OS of 21 (13-28) months and 2-year OS was 40.9 %. (p value = 0.572). Median OS for the patients in non-resected group (Group 3, n = 43) was 13 months and 2-year OS was 25.6%. There was no significant difference in DFS of the R0 resection patients in Group 1vs 2. (p value = 0.250). Median OS and 2-year OS of the patients who had R0 resection was significantly better than the patients who had R1 resection (27 vs 18 months, 55.9% versus 30.8% respectively, p value = 0.046). There was no difference in surgical complications or postoperative mortality between the two groups. Only 1 patient had grade 2 and 1 patient had grade 3 RT related late GI toxicity. 7 (23%) in Group 1 and 8 (36%) patients had Surgical morbidity. Patients diagnosed with BRPC with suboptimal response to NACT precluding resection, benefit from addition of SBRT by increasing the resectability rate and outcomes similar to the patients having partial or good response to NACT alone. SBRT does not lead to additional surgical or RT related late toxicity. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
FullText Text:
  Availability: 0
Header DbId: egs
DbLabel: Engineering Source
An: 179875896
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Addition of SBRT and Outcomes in Borderline Resectable Pancreatic Cancer Patients Having Suboptimal Response to Neoadjuvant Chemotherapy.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Engineer%2C+R%2E%22">Engineer, R.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pathare%2C+P%2E%22">Pathare, P.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bhandare%2C+M%2E%22">Bhandare, M.</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Krishnatry%2C+R%2E%22">Krishnatry, R.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gudi%2C+S%2E%22">Gudi, S.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ostwal%2C+V%2E%22">Ostwal, V.</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ramaswamy%2C+A%2E%22">Ramaswamy, A.</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shrikhande%2C+S%2E%22">Shrikhande, S.</searchLink><relatesTo>3</relatesTo> (AUTHOR)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. 2024 Supplement, Vol. 120 Issue 2, pe437-e438. 2p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Neoadjuvant+chemotherapy%22">Neoadjuvant chemotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Pancreatic+cancer%22">Pancreatic cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Overall+survival%22">Overall survival</searchLink><br /><searchLink fieldCode="DE" term="%22Surgical+complications%22">Surgical complications</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+patients%22">Cancer patients</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Role of SBRT in patients who do not respond to NACT is not yet well defined. We conducted this study to evaluate the impact of SBRT in borderline resectable pancreatic cancer patients with suboptimal response to NACT All consecutive patients staged as BRPC at our center from 2016 to 2020 were included. All received NACT with mFOLFIRINOX or NAB-PACLITAXEL (4-6 cycles) followed by surgical assessment. Patients with radiological partial response (PR) were surgically explored, those with poor response or stable disease not amenable to R0 resection received SBRT and additional chemotherapy followed by surgical assessment. SBRT consisted of 42 -45 Gy over 5 fractions in 10 days. A total of 151 patients with BRPC were registered. During NACT, 44(29%) patients either defaulted or progressed and 107 (69.9%) patients completed at least 4 cycles of NACT and response assessment CECT scan was done. Post NACT, 36(33.6%) patients with partial response were surgically explored, 22(73%) underwent R0 and 8 (24%) had R1 resection (Group 1, n = 30). Remaining 71(66.3%) patients had suboptimal response to NACT and were not feasible for R0 resection received additional SBRT and CT. Post SBRT 28(26.1%) patients were surgically explored and 17 (77%) underwent R0 resection whereas 5 (23%) had R1 resection (Group 2, n = 22). Remaining 43(40%) (Group 3, n = 43) patients continued to receive palliative chemotherapy. At median follow up of 18 months, Median overall survival (OS) and 2-year OS for the whole group (107 patients) was 18 (13-22) months and 37.1% respectively. Group 1 (Patients undergoing curative resection after NACT) had median OS of 26 (19-32) months and 2-year OS of 56 % while Group 2 (patients with addition of SBRT after NACT to achieve curative resection) had median OS of 21 (13-28) months and 2-year OS was 40.9 %. (p value = 0.572). Median OS for the patients in non-resected group (Group 3, n = 43) was 13 months and 2-year OS was 25.6%. There was no significant difference in DFS of the R0 resection patients in Group 1vs 2. (p value = 0.250). Median OS and 2-year OS of the patients who had R0 resection was significantly better than the patients who had R1 resection (27 vs 18 months, 55.9% versus 30.8% respectively, p value = 0.046). There was no difference in surgical complications or postoperative mortality between the two groups. Only 1 patient had grade 2 and 1 patient had grade 3 RT related late GI toxicity. 7 (23%) in Group 1 and 8 (36%) patients had Surgical morbidity. Patients diagnosed with BRPC with suboptimal response to NACT precluding resection, benefit from addition of SBRT by increasing the resectability rate and outcomes similar to the patients having partial or good response to NACT alone. SBRT does not lead to additional surgical or RT related late toxicity. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=179875896
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.ijrobp.2024.07.976
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 2
        StartPage: e437
    Subjects:
      – SubjectFull: Neoadjuvant chemotherapy
        Type: general
      – SubjectFull: Pancreatic cancer
        Type: general
      – SubjectFull: Overall survival
        Type: general
      – SubjectFull: Surgical complications
        Type: general
      – SubjectFull: Cancer patients
        Type: general
    Titles:
      – TitleFull: Addition of SBRT and Outcomes in Borderline Resectable Pancreatic Cancer Patients Having Suboptimal Response to Neoadjuvant Chemotherapy.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Engineer, R.
      – PersonEntity:
          Name:
            NameFull: Pathare, P.
      – PersonEntity:
          Name:
            NameFull: Bhandare, M.
      – PersonEntity:
          Name:
            NameFull: Krishnatry, R.
      – PersonEntity:
          Name:
            NameFull: Gudi, S.
      – PersonEntity:
          Name:
            NameFull: Ostwal, V.
      – PersonEntity:
          Name:
            NameFull: Ramaswamy, A.
      – PersonEntity:
          Name:
            NameFull: Shrikhande, S.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 02
              M: 10
              Text: 2024 Supplement
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 03603016
          Numbering:
            – Type: volume
              Value: 120
            – Type: issue
              Value: 2
          Titles:
            – TitleFull: International Journal of Radiation Oncology, Biology, Physics
              Type: main
ResultId 1