- 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.
- 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.
- Multi-institutional, retrospective study, 44 patients with inoperable pancreatic cancer.
- Outcomes: OS, freedom from local or distant failure.
- Funding: None.
- The authors say the findings are hypothesis-generating.
- Small sample with treatment heterogeneity.