Phase I study of stereotactic radiosurgery in patients with locally advanced pancreatic cancer.

PURPOSE To determine the feasibility and toxicity of delivering stereotactic radiosurgery to patients with locally advanced pancreatic cancer. METHODS AND MATERIALS Patients with Eastern Cooperative Oncology Group performance status < or=2 and locally advanced pancreatic cancer were enrolled on this Phase I dose escalation study. Patients received a single fraction of radiosurgery consisting of either 15 Gy, 20 Gy, or 25 Gy to the primary tumor. Acute gastrointestinal toxicity was scored according to the Radiation Therapy Oncology Group criteria. Response to treatment was determined by serial high-resolution computed tomography scanning. RESULTS Fifteen patients were treated at 3 dose levels (3 patients received 15 Gy, 5 patients received 20 Gy, and 7 patients received 25 Gy). At these doses, no Grade 3 or higher acute gastrointestinal toxicity was observed. This trial was stopped before any dose-limiting toxicity was reached, because the clinical objective of local control was achieved in all 6 evaluable patients treated at 25 Gy. CONCLUSIONS It is feasible to deliver stereotactic radiosurgery to patients with locally advanced pancreatic cancer. The recommended dose to achieve local control without significant acute gastrointestinal toxicity is 25 Gy.

[1]  A. Grann,et al.  ADJUVANT THERAPY FOR PANCREATIC CANCER: Current Treatment Approaches and Future Challenges , 2001 .

[2]  Alicia Samuels,et al.  Cancer Statistics, 2003 , 2003, CA: a cancer journal for clinicians.

[3]  K. Campbell,et al.  Pancreaticoduodenectomy With or Without Distal Gastrectomy and Extended Retroperitoneal Lymphadenectomy for Periampullary Adenocarcinoma, Part 2: Randomized Controlled Trial Evaluating Survival, Morbidity, and Mortality , 2002, Annals of surgery.

[4]  Quynh-Thu Le,et al.  The effectiveness of breath-holding to stabilize lung and pancreas tumors during radiosurgery. , 2002, International journal of radiation oncology, biology, physics.

[5]  M. Tempero,et al.  Current and future strategies for combined-modality therapy in pancreatic cancer , 2002, Current oncology reports.

[6]  J. Barkin,et al.  Therapy of locally unresectable pancreatic carcinoma: A randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads + 5‐fluorouracil), and high dose radiation + 5‐fluorouracil. The gastrointestinal tumor study group , 1981, Cancer.

[7]  F. Mícek.  [Cancer of the pancreas]. , 1965, Bratislavske lekarske listy.

[8]  V. Devita,et al.  Cancer : Principles and Practice of Oncology , 1982 .

[9]  Treatment of locally unresectable carcinoma of the pancreas: comparison of combined-modality therapy (chemotherapy plus radiotherapy) to chemotherapy alone. Gastrointestinal Tumor Study Group. , 1988, Journal of the National Cancer Institute.