Gastrointestinal Cancer

PV QA 1 - Poster Viewing Q&A 1

SU_16_2163 - Proton Beam Therapy for Inoperable Stage Pancreatic Cancer

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

Proton Beam Therapy for Inoperable Stage Ⅲ Pancreatic Cancer
T. Arimura, N. Kondo, M. Matsuyama, I. Kitano, T. Mukoyoshi, I. Nagata, and T. Ogino; Medipolis Proton Therapy and Research Center, Ibusuki, Japan

Purpose/Objective(s): Few patients with pancreatic cancer (PC) survive to 5 years after diagnosis, and surgical resection offers the only chance of cure. Proton beam therapy (PBT) has shown promising results for various tumors; however, it remains unclear whether it could improve the prognosis for patients with inoperable PC. We evaluated the efficacy and the toxicity of PBT for patients with stage Ⅲ PC.

Materials/Methods: We analyzed 82 patients with stage Ⅲ PC who had received concurrent chemo-PBT between Apr. 2011 and Jun. 2016. Fifty-seven (70%) patients were given a dose of 67.5 Gy equivalents (GyE) using a field-in-field technique (FFT), and the other 25 patients (30%) were prescribed a dose of 50 GyE for delivery to the planning target volume (PTV). The numbers of patients receiving chemotherapeutic agents were as follows: 37 for gemcitabine alone (45%), 25 (30%) for S-1 alone, and 20 (24%) for others. Nineteen (23%) patients were inserted a metallic stent into the bile duct during PBT.

Results: The median age and follow up period were 68 years old (range: 27–87 years old) and 22 months (range: 4–83 months), respectively. The median overall survival (OS) and progression-free survival (PFS) were 22 months and 15 months, respectively. There was no significant difference in OS and PFS between the two prescription doses. The occurrence of grade 3 or greater hematological toxicities was 1 (1%) in anemia, 15 (18%) in leukopenia, and 2 (2%) in thrombocytopenia, respectively. The incidence of grade 3 or greater gastrointestinal toxicities in the late phase was 4 (5%) in bleeding, 2 (2%) in ulcer, 3 (4%) in stenosis, and 1 (1%) in fistula, respectively. We did not observe a substantial interaction between gastrointestinal toxicities and metallic stents in the bile duct in the study.

Conclusion: The study showed the feasibility and tolerability of PBT for patients with stage Ⅲ PC. We also demonstrated promising results suggesting that the prognosis for patients with locally advanced PC can be improved. Further investigation is needed to ascertain a definite role for PBT in pancreatic cancer treatment.

Author Disclosure: T. Arimura: None. N. Kondo: None. M. Matsuyama: None. I. Kitano: None.

Takeshi Arimura, MD, PhD

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