Gastrointestinal Cancer

PV QA 1 - Poster Viewing Q&A 1

SU_18_2187 - A Phase I Trial of High-Dose SBRT Followed by the Gastrointestinal Shunt Procedure for Local Pancreatic Head and Neck Carcinoma: to Approach a New Mode of Cooperation of Radiation Therapy and Surgery

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

A Phase I Trial of High-Dose SBRT Followed by the Gastrointestinal Shunt Procedure for Local Pancreatic Head and Neck Carcinoma: to Approach a New Mode of Cooperation of Radiation Therapy and Surgery
G. Ren1, Z. Feng2, F. Zhu1, Y. Wang1, and T. Xia1; 1Department of Radiation Oncology, Chinese PLA Air Force General Hospital, Beijing, China, 2Department of Hepatobiliary Surgery, Chinese PLA Air Force General Hospital, Beijing, China

Purpose/Objective(s): There are severe side effects with radical high-dose radiotherapy for pancreatic cancer that is adjacent to or infiltrates the surrounding gastrointestinal tract. A gastrointestinal shunt procedure may not let the food pass through the irradiated digestive tract to reduce gastrointestinal side effects after radiotherapy. This phase I study was conducted to investigate the safety and feasibility of high-dose SBRT followed by the gastrointestinal shunt procedure for locally pancreatic head and neck cancer (LAPHNC).

Materials/Methods: Eligible patients with LAPHNC were involved in our study prospectively for high-dose SBRT with helical tomotherapy. The pancreatic lesion and surrounded metastatic lymph nodes were defined as gross tumor volume. Give a prescriptive dose of 60Gy and 50Gy to GTV and CTV, 12Gy per daily fraction in five days. The gastrointestinal shunt procedure that included gastrointestinal and intestino-intestinal anastomosis, not moving the tumor, was then performed in a week after radiotherapy. Treatment related toxicity was evaluated during the radiotherapy and after resection according to NCI-CTCAE 4.02. RECIST1.1 and PERCIST1.0 should be adopted to evaluate the recent treatment effect.

Results: Till Dec 2017, a total of 10 patients aged 39-64 were enrolled (7 for pancreatic head cancer, 2 for head-neck and 1 for neck). The tumor volume ranged from 9.42 cm3 to 75.45cm3 (median 44.81 cm3), and 4 patient was suggested radiographic lymph node metastases. All patients underwent the radiotherapy followed by the surgery well. The median dose of GTV D95 was 55 Gy and CTV D95 was 45 Gy. The average of D5cc was 27.82Gy for stomach, 36.1Gy for duodenum respectively. The average of gastric D10cc was 22.2Gy, duodenum 30.68Gy respectively. The clinical follow-up time was ranged from 1 to 23 months. Only 1 case appeared abdominal pain (grade Ⅲ) 2 months after surgery. There were 100% pain relief (8/8) and local control (10/10). According to RECIST1.1 standard, objective response rate (ORR) was 33.3%. According to PERCIST1.0 standard, complete metabolic response (CMR) plus partial metabolic response (PMR) was 100%.

Conclusion: The new regimen of high-dose SBRT followed by duodenal shunt surgery is safe and tolerable in patients with LACHNPC. Clinical outcomes showed a high pain control and latest local control rate.

Author Disclosure: G. Ren: None. Z. Feng: None.

Send Email for Tingyi Xia


Assets

SU_18_2187 - A Phase I Trial of High-Dose SBRT Followed by the Gastrointestinal Shunt Procedure for Local Pancreatic Head and Neck Carcinoma: to Approach a New Mode of Cooperation of Radiation Therapy and Surgery



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for A Phase I Trial of High-Dose SBRT Followed by the Gastrointestinal Shunt Procedure for Local Pancreatic Head and Neck Carcinoma: to Approach a New Mode of Cooperation of Radiation Therapy and Surgery