Gastrointestinal Cancer

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SU_17_2168 - Stereotactic Body Radiation Therapy (SBRT) Reirradiation after prior SBRT for pancreas cancer - outcomes and toxicity

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

Stereotactic Body Radiation Therapy (SBRT) Reirradiation after prior SBRT for pancreas cancer – outcomes and toxicity
J. F. Duran1, and T. R. Chapman2; 1Beth Israel Deaconess Medical Center, Boston, MA, 2Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

Purpose/Objective(s): Stereotactic Body Radiation Therapy (SBRT) is an emerging treatment modality for patients with pancreatic cancer. Dose delivery to the tumor is often limited by critical organs at risk (OAR), leading to a small cohort of patients with local only recurrence. We hypothesize that SBRT reirradiation is a safe and effective technique for these patients.

Materials/Methods: Review of our IRB approved institutional database revealed 30 patients (15 women and 15 men) with a median age of 68 years who had received 2 SBRT courses for pancreatic cancer. Patients were treated with a radiosurgery platform using fiducials and respiratory motion tracking. Chart review was performed for demographic, treatment and outcome variables. Data were analyzed using STATA and the R programming language.

Results: Of the 30 patients identified, 15 received repeat SBRT for primary recurrence, 10 for post-operative positive margins, and 5 for disease in a new site. The median dose of the first course was 24Gy, with an average of 3 fractions, and 25Gy in 5 fractions for the second course. Median time to retreatment was 12 months. Median OS was 24 months. There were no Grade III or greater toxicities. Median OS after retreatment was 16 months.

Conclusion: SBRT reirradiation after prior SBRT appears to be safe and effective in this small cohort of patients, and represents a promising treatment option for patients with recurrent disease. Further work examining dosimetric predictors of outcome and toxicity are pending.

Author Disclosure: J.F. Duran: None. T.R. Chapman: Independent Contractor; Coviden.

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