Department of Radiation Oncology, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.
Department of Hepatobiliary and Pancreatic Surgery, Changhai Hospital affiliated to Naval Medical University, Shanghai, China.
Radiat Oncol. 2024 Aug 19;19(1):111. doi: 10.1186/s13014-024-02493-8.
Local therapies may benefit patients with oligometastatic cancer. However, there were limited data about pancreatic cancer. Here, we compared the efficacy and safety of stereotactic body radiation therapy (SBRT) to the primary tumor and all oligometastases with SBRT to the primary tumor alone in patients with metastatic pancreatic cancer.
A retrospective review of patients with synchronous oligometastatic pancreatic cancer (up to 5 lesions) receiving SBRT to all lesions (including all oligometastases and the primary tumor) were performed. Another comparable group of patients with similar baseline characteristics, including metastatic burden, SBRT doses, and chemotherapy regimens, receiving SBRT to the primary tumor alone were identified. The primary endpoint was overall survival (OS). The secondary endpoints were progression frees survival (PFS), polyprogression free survival (PPFS) and adverse events.
There were 59 and 158 patients receiving SBRT to all lesions and to the primary tumor alone. The median OS of patients with SBRT to all lesions and the primary tumor alone was 10.9 months (95% CI 10.2-11.6 months) and 9.3 months (95% CI 8.8-9.8 months) (P < 0.001). The median PFS of two groups was 6.5 months (95% CI 5.6-7.4 months) and 4.1 months (95% CI 3.8-4.4 months) (P < 0.001). The median PPFS of two groups was 9.8 months (95% CI 8.9-10.7 months) and 7.8 months (95% CI 7.2-8.4 months) (P < 0.001). Additionally, 14 (23.7%) and 32 (20.2%) patients in two groups had grade 3 or 4 treatment-related toxicity.
SBRT to all oligometastases and the primary tumor in patients with pancreatic cancer may improve survival, which needs prospective verification.
局部治疗可能使寡转移癌症患者受益。然而，关于胰腺癌的数据有限。在这里，我们比较了立体定向体放射治疗（SBRT）治疗转移胰腺癌患者原发肿瘤和所有寡转移灶与单纯治疗原发肿瘤的疗效和安全性。
对接受所有病变（包括所有寡转移灶和原发肿瘤）SBRT 的同步寡转移性胰腺癌（最多 5 个病灶）患者进行回顾性分析。还确定了另一组具有相似基线特征的可比患者，包括转移负荷、SBRT 剂量和化疗方案，仅接受 SBRT 治疗原发肿瘤。主要终点是总生存期（OS）。次要终点是无进展生存期（PFS）、无进展生存期（PPFS）和不良事件。
有 59 例和 158 例患者分别接受了所有病变和单独原发肿瘤的 SBRT。所有病变和单独原发肿瘤 SBRT 的中位 OS 分别为 10.9 个月（95%CI 10.2-11.6 个月）和 9.3 个月（95%CI 8.8-9.8 个月）（P<0.001）。两组的中位 PFS 分别为 6.5 个月（95%CI 5.6-7.4 个月）和 4.1 个月（95%CI 3.8-4.4 个月）（P<0.001）。两组的中位 PPFS 分别为 9.8 个月（95%CI 8.9-10.7 个月）和 7.8 个月（95%CI 7.2-8.4 个月）（P<0.001）。此外，两组中有 14 例（23.7%）和 32 例（20.2%）患者发生 3 级或 4 级治疗相关毒性。
SBRT 治疗胰腺癌患者的所有寡转移灶和原发肿瘤可能改善生存，这需要前瞻性验证。
