Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2015; 21(26): 8156-8162
Published online Jul 14, 2015. doi: 10.3748/wjg.v21.i26.8156
Stereotactic body radiotherapy using CyberKnife for locally advanced unresectable and metastatic pancreatic cancer
Ting-Shi Su, Ping Liang, Huan-Zhen Lu, Jian-Ning Liang, Jian-Min Liu, Ying Zhou, Ying-Chuan Gao, Min-Yang Tang
Ting-Shi Su, Ping Liang, Huan-Zhen Lu, Jian-Ning Liang, Jian-Min Liu, Ying Zhou, Ying-Chuan Gao, Min-Yang Tang, Department of Radiation Oncology, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, Nanning 530001, Guangxi Zhuang Autonomous Region, China
Author contributions: Su TS and Liang P performed the majority of experiments and designed the study; Su TS wrote the manuscript; Lu HZ and Liang JN collected all the clinical materials; Liu JM, Zhou Y, Gao YC and Tang MY provided vital reagents and analytical tools and were also involved in revising the manuscript.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of Rui Kang Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Data sharing statement: Statistical code and dataset available from the corresponding author at sutingshi@163.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Ting-Shi Su, Department of Radiation Oncology, Rui Kang Hospital, Guangxi Traditional Chinese Medical University, No. 10 Huadong Road, Nanning 530001, Guangxi Zhuang Autonomous Region, China. sutingshi@163.com
Telephone: +86-771-2250120 Fax: +86-771-2250120
Received: January 7, 2015
Peer-review started: January 8, 2015
First decision: January 22, 2015
Revised: February 3, 2015
Accepted: March 18, 2015
Article in press: March 19, 2015
Published online: July 14, 2015
Abstract

AIM: To evaluate the efficacy and toxicity of stereotactic body radiotherapy using CyberKnife for locally advanced unresectable and metastatic pancreatic cancer.

METHODS: From June 2010 to May 2014, 25 patients with locally advanced unresectable and metastatic pancreatic cancer underwent stereotactic body radiotherapy. Nine patients presented with unresectable locally advanced disease and 16 had metastatic disease. Primary end-points of this study were overall survival, relief of abdominal pain, and toxicity.

RESULTS: Fourteen patients were treated with a total dose of 30-36 Gy in three fractions and the remainder with 40-48 Gy in four fractions. Median follow-up was 11 mo (range: 2-25 mo). The median survival duration calculated from the time of stereotactic body radiotherapy for the entire group, the locally advanced group, and the metastatic group was 9.0 mo, 13.5 mo, and 8.5 mo, respectively. Overall survival was 37% and 18% at one and two years, respectively. Abdominal pain relief was achieved within 2 wk of completing radiotherapy in the patients who received successful palliation (13 of 20 patients had significant pain). Five patients (20%) had grade 1 nausea, and one (4%) had grade 2 nausea. No acute grade 3+ toxicity was seen.

CONCLUSION: Stereotactic body radiotherapy using the CyberKnife system is a promising, noninvasive, palliative treatment with acceptable toxicity for locally advanced unresectable and metastatic pancreatic cancer.

Keywords: CyberKnife, Pancreatic cancer, Stereotactic body radiotherapy

Core tip: Locally advanced unresectable and metastatic pancreatic cancer is the most common presentation of pancreatic cancer. The available therapeutic option is chemotherapy or chemoradiotherapy. The low-dose radiation of conventional radiotherapy has unsatisfactory results for survival and local control, at a cost of increased hematologic toxicity. Doses > 54 Gy may be considered if clinically appropriate. Stereotactic body radiation therapy has become an important research topic to provide a higher biologically effective dose. We evaluated the efficacy and toxicity of stereotactic body radiation therapy using the CyberKnife system for patients with locally advanced unresectable and metastatic pancreatic cancer.