A non-surgical COMBO-therapy approach for locally advanced unresectable pancreatic adenocarcinoma: preliminary results of a prospective study

Radiol Med. 2022 Feb;127(2):214-219. doi: 10.1007/s11547-021-01441-w. Epub 2022 Jan 15.

Abstract

In this short report we present a series of thirteen patients with locally advanced, unresectable, pancreatic cancer treated with a COMBO-Therapy consisting of: STEP-1: induction chemotherapy; STEP-2: concomitant chemoradiotherapy; STEP-3: stereotactic body radiotherapy boost. After four weeks from the end of each step all patients had a re-staging and a surgical re-evaluation. All patients completed STEP-1 and STEP-2. STEP-3 has been successfully delivered to 8/13 patients with a median dose of 12 Gy (range 10-21 Gy) in 1-3 fractions. The median LC was 20 months (range 10-32) with a 2-year LC of 72.9%, and none of the patients developed G3 acute or late toxicities. The median OS was 21.5 months (range 12-34), and the 2-year OS was 53.9%; the median PFS was 17.5 months (range 10-27). Our non-surgical COMBO-Therapy has demonstrated a feasible profile with good tolerance. Further prospective protocols are needed to confirm our preliminary results.

Keywords: Chemotherapy; Pancreatic cancer; Radiotherapy; Stereotactic radiotherapy.

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / therapy*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemoradiotherapy / methods*
  • Diagnostic Imaging / methods
  • Humans
  • Pancreas / diagnostic imaging
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / therapy*
  • Prospective Studies
  • Radiosurgery / methods*
  • Treatment Outcome