![]() ![]() Re-irradiation with SBRT has been successfully applied in lung cancer, head and neck cancer, bone metastases, and other cancers ( 9– 12). The alternative aggressive approaches for local recurrence are warranted to improve the clinical outcomes. Because of the symptomatic manifestations such as pain, obstruction, portal hypertension, and malnutrition, local progression is an important factor contributing to poor prognosis and deteriorations of quality of life ( 7, 8). However, nearly one-third of patients treated with chemoradiation have local–regional recurrence ( 5), and 30% of deaths are due to locally progressive disease ( 6). ![]() Stereotactic body radiotherapy (SBRT) is a promising treatment for pancreatic cancer with an excellent local control and acceptable toxicity ( 4). The incidence and mortality have increased dramatically, and pancreatic cancer is projected to arise as the second leading cause of cancer-related deaths in Europe and the United States by 2030 ( 1– 3). Pancreatic cancer is one of the most lethal malignancies. ![]() None of the patients experienced gastrointestinal toxicity.Ĭonclusions: Re-irradiation with SBRT can provide favorable outcomes and effective analgesia with mild toxicity after prior SBRT for in-field recurrent pancreatic cancer, which might be feasible for locally relapsed pancreatic cancer. Twelve (75%) out of 16 patients had pain relief after re-irradiation. Carbohydrate antigen 19-9 (CA19-9) levels declined dramatically after re-irradiation within 1 month (p = 0.002) and 3 months (p = 0.028). The overall response rate and disease control rate were 50% and 13%, and 100% and 86.9% after each SBRT, respectively. The median OS of 12 patients without metastasis was 14 months (95% CI: 10.6–17.4 months) from re-irradiation of SBRT. From the first SBRT, the median OS of 18 patients with limited diseases was 26 months (95% CI: 19.1–32.95 months). Results: The median interval between two courses of SBRT was 13 months (range: 6–29 months). Clinical outcomes including overall survival (OS), disease control, and toxicity were evaluated after treatment. The median prescription dose of the initial and second courses of SBRT was 35.5 Gy/5–7f and 32 Gy/5–8f, respectively. Material/Methods: Twenty-four consecutive patients with pancreatic cancer received two courses of SBRT in our center between January 2014 and December 2016. The aim of the study was to investigate the feasibility of re-irradiation with SBRT for locally recurrent pancreatic cancer after prior definitive SBRT. However, the safety and efficacy of SBRT for in-field recurrence after initial SBRT remain unknown. Stereotactic body radiotherapy (SBRT) is a promising treatment for pancreatic cancer with an excellent local control and acceptable toxicity. Purpose/Objectives: Locally recurrent pancreatic cancer is a therapeutic challenge, and aggressive approaches are needed to improve its clinical outcomes.
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