Effect of stereotactic body radiation therapy on the survival of patients with pancreatic cancer recurrence after surgery

Abstract

Objective To identify the effect of stereotactic body radiation therapy (SBRT) on the survival of patients with recurrent pancreatic cancer after surgery. Methods The data of 104 patients with recurrent pancreatic cancer after surgery who underwent SBRT in the Department of Radiation Oncology of Changhai Hospital, Navy Medical University from February 2012 to December 2016 were retrospectively analyzed. The prescription doses ranged from 35-40 Gy/4-8 f. Survival analysis was performed using the Kaplan-Meier method, and relevant factors affecting patients′ survival were screened by the Cox proportional hazards model. Results The median overall survival (OS) and progression free survival (PFS) was 12.5 (11.0-14.0) months and 7.3 (6.0-8.7) months, respectively, while the 1-year rate of OS and PFS was 55.8% and 22.1%, respectively. Multivariate analysis indicated that tumor stage, biological effect dose (α/β=10, BED10), the decrease of CA19-9 level after treatment, and follow-up chemotherapy were all related factors affecting overall survival; tumor stage, BED10, the degree of pain relief and the decrease of CA19-9 level after treatment were related factors affecting PFS. Conclusions Patients suffering recurrent pancreatic cancer with early tumor stage, normal CA19-9 level and mild pain before treatment could be better treated by SBRT, BED10≥60 Gy and follow-up chemotherapy after radiotherapy can prolong the survival of patients. Key words: Pancreatic neoplasms; Radiotherapy; Recurrence; Treatment outcome