Is there an oligometastatic state in pancreatic cancer? Practical clinical considerations raise the question

Br J Radiol. 2020 Feb 1;93(1106):20190627. doi: 10.1259/bjr.20190627. Epub 2019 Dec 18.

Abstract

Objectives: To evaluate the role of stereotactic body radiotherapy (SBRT) as a local ablative treatment (LAT) in oligometastatic pancreatic cancer.

Methods: Patients affected by histologically confirmed stage IV pancreatic adenocarcinoma were included in this analysis. Endpoints are local control (LC), progression-free survival (PFS), and overall survival (OS).

Results: From 2013 to 2017, a total of 41 patients were treated with SBRT on 64 metastases. Most common sites of disease were lung (29.3%) and liver (56.1%). LC at 1 and 2 years were 88.9% (95% CI 73.2-98.6) and 73.9% (95% CI 50-87.5), respectively. Median LC was 39.9 months (95% CI 23.3-not reached).PFS rates at 1 and 2 years were 21.9% (95% CI 10.8-35.4) and 10.9% (95% CI 3.4-23.4), respectively. Median PFS was 5.4 months (95%CI 3.1-11.3).OS rates at 1 and 2 years were 79.9% (95% CI 63.7-89.4) and 46.7% (95% CI 29.6-62.2). Median OS was 23 months (95%CI 14.1-31.8).

Conclusions: Our results, although based on a retrospective analysis of a small number of patients, show that patients with oligometastatic pancreatic cancer may benefit from local treatment with SBRT. Larger studies are warranted to confirm these results.

Advances in knowledge: Selected patients affected by oligometastatic pancreatic adenocarcinoma can benefit from local ablative approaches, like SBRT.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / radiotherapy*
  • Aged
  • Aged, 80 and over
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / radiotherapy*
  • Positron-Emission Tomography
  • Radiosurgery / methods*
  • Radiosurgery / mortality
  • Retrospective Studies