Pancreatic cancer: MR-guided radiotherapy boosts survival

  • Rudra S & al.
  • Cancer Med
  • 1 Apr 2019

  • curated by Emily Willingham, PhD
  • Univadis Clinical Summaries
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Takeaway

  • High-dose adaptive magnetic resonance-guided radiation therapy (MRgRT) yields improved survival without increasing acute toxicity in patients with inoperable pancreatic cancer.

Why this matters

  • Approach allows daily adaptation of treatment plans, improving coverage of the target volume within constraints of gastrointestinal organ deformation and movement.

Key results

  • Patients receiving high-dose MRgRT (n=24) had greater 2-year OS vs standard-dose group (n=20):
    • 49% vs 30% (P=.03).
  • They also showed a trend to higher 2-year freedom from local failure, but it was not significantly greater vs standard dose (77% vs 57%; P=.15).
  • Freedom from distant failure was not better with high dose: 24% vs 48% (P=.92).
  • Although high-dose radiation and induction chemotherapy correlated with OS on univariate analysis, they did not remain predictive on multivariate analysis.
  • Standard-dose group had 3 patients with grade 3 gastrointestinal toxicity; none with high dose.

Study design

  • Multi-institutional, retrospective study, 44 patients with inoperable pancreatic cancer.
  • Outcomes: OS, freedom from local or distant failure.
  • Funding: None.

Limitations

  • The authors say the findings are hypothesis-generating.
  • Small sample with treatment heterogeneity.

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