Seo Youngseok, Kim Mi-Sook, Yoo Sungyul, Cho Chulkoo, Yang Kwangmo, Yoo Hyungjun, Choi Chulwon, Lee Donghan, Kim Jin, Kim Min Suk, Kang Hyejin, Kim Younghan
Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1456-61. doi: 10.1016/j.ijrobp.2009.01.042. Epub 2009 Sep 23.
To investigate the clinical application of a stereotactic body radiation therapy (SBRT) boost in locally advanced pancreatic cancer patients with a focus on local efficacy and toxicity.
We retrospectively reviewed 30 patients with locally advanced and nonmetastatic pancreatic cancer who had been treated between 2004 and 2006. Follow-up duration ranged from 4 to 41 months (median, 14.5 months). A total dose of 40 Gy was delivered in 20 fractions using a conventional three-field technique, and then a single fraction of 14, 15, 16, or 17 Gy SBRT was administered as a boost without a break. Twenty-one patients received chemotherapy. Overall and local progression-free survival were calculated and prognostic factors were evaluated.
One-year overall survival and local progression-free survival rates were 60.0% and 70.2%, respectively. One patient (3%) developed Grade 4 toxicity. Carbohydrate antigen 19-9 response was found to be an independent prognostic factor for survival.
Our findings indicate that a SBRT boost provides a safe means of increasing radiation dose. Based on the results of this study, we recommend that a well controlled Phase II study be conducted on locally advanced pancreatic cancer.
探讨立体定向体部放射治疗（SBRT）增敏在局部晚期胰腺癌患者中的临床应用，重点关注局部疗效和毒性。
我们回顾性分析了2004年至2006年间接受治疗的30例局部晚期且无转移的胰腺癌患者。随访时间为4至41个月（中位数为14.5个月）。采用传统的三野技术分20次给予总剂量40 Gy，然后不间隔地单次给予14、15、16或17 Gy的SBRT增敏。21例患者接受了化疗。计算总生存和局部无进展生存率，并评估预后因素。
1年总生存率和局部无进展生存率分别为60.0%和70.2%。1例患者（3%）出现4级毒性反应。糖类抗原19-9反应被发现是生存的独立预后因素。
我们的研究结果表明，SBRT增敏提供了一种增加放射剂量的安全方法。基于本研究结果，我们建议对局部晚期胰腺癌进行一项严格控制的II期研究。
