Abstract
Purpose/objective: To analyse outcome and toxicity of stereotactic body radiotherapy (SBRT) in pancreatic
cancer (PDAC). Material/methods: We systematically reviewed full reports on outcome and toxicity transforming prescription
doses to equivalent doses of 2 Gy (EQD2) and biological equivalent doses (BED). Pearson product-moment correlation
coefficient, regression analysis and Lyman–Kutcher–Burman modelling were used. Results: Sixteen trials (572 patients) were identified. Local control correlated with dose.
Additionally 4 upper gastrointestinal-SBRT trials (149 patients) were included for
toxicity analysis. Acute toxicity was mild but late toxicity ⩾G2 was substantial and
predominantly gastrointestinal. Late toxicity ⩾G2 and ⩾G3 correlated highly with EQD2/BED
after linear (R2 = 0.85 and 0.77, respectively) and Lyman–Kutcher–Burman modelling. Linear regression
lines indicated ⩾G2 and ⩾G3 toxicity frequencies of 5% at 65 Gy and 80 Gy EQD2-α/β = 3, respectively. A comparison of toxicity with dose constraints for duodenum revealed
partly inadequate dose constraints. Conclusion: Results from multiple fraction regimens could be successfully interpreted to estimate
toxicity according to EQD2/BED prescription doses, and dose constraints for the duodenum
were derived, whereas local control appeared to be less dose-dependent. This analysis
may be useful to plan clinical trials for SBRT and hypofractionated radiotherapy in
pancreatic cancer.
Keywords
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Article info
Publication history
Published online: November 25, 2014
Accepted:
October 31,
2014
Received in revised form:
October 7,
2014
Received:
August 7,
2014
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
