Abstract 353P
Background
Pancreatic cancer has a poor prognosis and is often diagnosed in elderly patients who may be ineligible for surgery or chemoradiation due to their age and comorbidities. A novel approach to the treatment of pancreatic cancer is stereotactic body radiotherapy (SBRT), which consists of the precise application of high-dose radiation in few fractions to a limited target volume. The aim of our study is to evaluate the efficacy and safety of SBRT in elderly pancreatic cancer patients.
Methods
All patients in the study cohort had a histologically proven diagnosis of pancreatic cancer. Exclusive SBRT was administered with three schedules: 30 Gy in 5 fractions (fr), 35 Gy in 5 fr and 45 Gy in 5 fr according to the tolerance of the adjacent normal tissues.The primary outcome was local control, assessed by CT scan or 18F-FDG PET-CT scan. Acute and late toxicities were assessed using the CTCAE scale, version 5.0.
Results
26 patients were enrolled (9 men, 17 women) with a median age of 77 years (range 58-90) between July 2018 and May 2023. In terms of surgery, pancreatic disease was defined as resectable or borderline resectable in 20 patients (77%) while in 6 cases (23%) it was considered unresectable. 15 patients (57.8%) were unfit for surgery due to comorbidities and 5 patients refused surgery (19.2%). Within the cohort 20 patients (77%) were treated with 30 Gy in 5 fr (6 Gy/day), 5 patients (19.2%) with 35 Gy in 5 fr (7 Gy/day) and 1 patient (3.8%) with 45 Gy in 5 fr (9 Gy/day). Median follow-up was 11.4 months (range 0.5 - 25.6). Among the 26 patients who received SBRT, median PFS was 26.1 months. One-year and two-year PFS rates were 79% and 60%. Median LPFS was 33.3 months. One-year and two-year LPFS rates were 86% and 70% (Fig 1). Median MFS was 29.6 months. One-year and two-year MFS rates were 85% and 79%. Median OS was 30 months, with one-year and two-year OS rates of 78% and 57%. SBRT was well tolerated with no acute toxicities observed, while late toxicities were observed in only 2 patients (7.7%), including one pancreatic fistula (G3) and one duodenal stenosis (G3).
Conclusions
In our experience SBRT has proven to be an effective and safe therapeutic approach in elderly patients with pancreatic cancer, with an impressive local control rate and no significant toxicities.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.