High dose may be key for pancreatic cancer radiation benefit
medwireNews: Findings presented at the 36th European Society for Radiation and Oncology (ESTRO) conference suggest that patients with early-stage pancreatic cancer could derive an overall survival (OS) benefit from high doses of adjuvant radiotherapy given alongside chemotherapy.
“Previous research has not shown a benefit for treating pancreatic cancer with radiotherapy, suggesting that these tumours are somehow resistant to radiation, but this study suggests the situation is more nuanced,” presenting author Francesco Cellini (Università Cattolica del Sacro Cuore, Rome, Italy) told the audience in Vienna, Austria.
“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 said.
Cellini and team stratified by radiation dose 514 patients with nonmetastatic disease who received chemoradiotherapy after surgery resulting in macroscopically negative margins (R0–1) and found that increasing doses were associated with improved survival.
For instance, median OS was 28 months for participants given a dose of at least 55 Gy, compared with 13 months for those who received less than 45 Gy of radiation.
For patients given doses of at least 50 Gy but less than 55 Gy and those treated with between 45 and 50 Gy of radiation, the median OS times were 22 and 21 months, respectively, with significant differences between the four groups.
The results were backed up by the multivariate analysis, which showed that patients given at least 55 Gy of postoperative radiation had a significant 55% reduced risk of death than those given a dose below 45 Gy.
“This study suggests radiotherapy should be considered for patients with early stage pancreatic cancer,” Cellini concluded.
The president of ESTRO, Yolande Lievens, from Ghent University Hospital in Belgium, told the press that the study “raises questions about the role that radiotherapy could play in extending the lives of people diagnosed with pancreatic cancer.”
She added: “Radiotherapy has evolved and improved considerably over recent years, allowing us to deliver higher doses without increasing side effects, and, for a cancer with such poor survival rates, all promising new options should be explored.”
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