Abstract 366P
Background
In the treatment of pancreatic ductal adenocarcinoma (PDAC) systemic control with chemotherapy is key, but it is known that about 30% of patients could die with locally destructive pancreatic cancer. Local stereotactic body radiation therapy (SBRT) could avoid commitment of anatomic structures near the pancreas minimizing delays in systemic therapy.
Methods
We aimed to analyze the local control rate according to RECIST 1.1, survival, pain relief and safety outcomes of patients submitted to pancreatic SBRT. Real-world data from medical records was collected retrospectively from patients with PDAC who underwent SBRT in the pancreatic lesion treated in a single center in Brazil from January 2017 to July of 2023.
Results
Fifty-one patients were included in this analysis. The median age was 64 years old. The median CA 19-9 at diagnosis was 251 U/mL. Forty-six patients (90.2%) received chemotherapy. The median SBRT dose was 33Gy in 3-5 days. In the first image after the SBRT 39 (83%) of the patients had stable disease and 4 (8.5%) had partial response. Forty-three (93.5%) patients achieved local control in the first image evaluation and the median time to local progression was 11.97 months. With a median follow-up time of 23.94 months, the median overall survival was 27 months for all staging. A survival advantage was found for the patients submitted to more than two lines of chemotherapy regimens during the disease (34.36 compared to 19.89 months) with p=0.012. Sixteen patients (31.4%) have reported abdominal pain associated to the pancreatic cancer. After SBRT 13 (86.7%) have reported pain relief. Nine patients (17.64%) have had adverse events due to the SBRT and 3 (5.88%) were grade 3 or 4 but none resulted in patient-related death.
Conclusions
This was a hypotheses-generating study that shows the outcomes from real-world data from patients with PDAC treated with locoregional SBRT in Brazil. The local control and overall survival were encouraging. As systemic therapies for pancreatic cancer continue to emerge with little increase in the overall survival, local control could be important to maintain the patient out of local complications, avoiding hospital admissions, improving the pain and giving a better quality of life.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.