Hypofractionated intensity-modulated radiotherapy with concurrent chemotherapy for elderly patients with locally advanced pancreatic carcinoma.
Hypofractionated intensity-modulated radiotherapy with concurrent chemotherapy for elderly patients with locally advanced pancreatic carcinoma.
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DOI：
10.1186/s13014-020-01712-2
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发表时间：
2020-11-13
期刊：
影响因子：
--
通讯作者：
Mizowaki T
中科院分区：
文献类型：
--
作者：
Iwai T;Yoshimura M;Ashida R;Goto Y;Kishi T;Itasaka S;Shibuya K;Kanai M;Masui T;Fukuda A;Isoda H;Hiraoka M;Mizowaki T
了解如何治疗老年局部晚期胰腺癌（LAPC）患者非常重要，因为老年癌症患者的数量将会增加。然而，老年 LAPC 患者的最佳治疗方案仍不清楚。本研究的目的是评估大分割调强放疗 (IMRT) 联合吉西他滨治疗老年 LAPC 患者的疗效和安全性。我们回顾性分析了 2013 年 2 月至 2018 年 12 月期间在我们机构接受大分割 IMRT（15 次 48 Gy）同时每周一次吉西他滨治疗的年龄≥75 岁 LAPC 患者的数据。总生存期 (OS)、无进展生存期 (PFS)、局部区域无进展生存期 (LRPFS)、远处无转移生存期 (DMFS) 以及复发和转移模式毒性进行了分析。十五名患者在研究期间接受了治疗。中位年龄为 78 岁（范围 75-86 岁），所有患者的东部肿瘤合作组 (ECOG) 体能状态 (PS) 为 0-1。中位生存时间 (MST) 和中位 PFS 分别为 20.4 [95% CI 10.3–36.8] 和 13.5 (95% CI 6.4–20.3) 个月，1 年 OS 和 PFS 率为 80.0% (95% CI 50–93.1%) 和 66.7% (95% CI 37.5–84.6%）。中位 LRPFS 和中位 DMFS 分别为 15.6 (95% CI 6.4–36.8) 和 14.9 (95% CI 7.0–20.5) 个月，1 年 LRPFS 和 DMFS 率为 73.3% (95% CI 43.6–89.1%) 和 66.7% (95% CI 37.5–84.6%）。 3 例观察到非血液学 3 级毒性，其中仅 1 例由放疗引起，而未观察到 4-5 级非血液学急性或迟发毒性。采用大分割IMRT联合吉西他滨治疗的老年LAPC患者的OS和PFS良好，且未发生严重毒性。这种治疗策略对于PS良好的老年LAPC患者来说是可行且有希望的。
It is important to understand how elderly patients with locally advanced pancreatic carcinoma (LAPC) should be treated, since the number of elderly cancer patients will increase. However, the optimal treatment for elderly patients with LAPC remains unclear. The purpose of this study was to evaluate the efficacy and safety of hypofractionated intensity-modulated radiotherapy (IMRT) with concurrent gemcitabine for elderly patients with LAPC. We retrospectively analysed the data from LAPC patients aged ≥ 75 years treated with hypofractionated IMRT (48 Gy in 15 fractions) with concurrent weekly gemcitabine at our institution from February 2013 to December 2018. Overall survival (OS), progression-free survival (PFS), locoregional progression-free survival (LRPFS), distant metastasis-free survival (DMFS), and the pattern of recurrence and toxicity were analysed. Fifteen patients received treatment during the study period. The median age was 78 years (range 75–86 years), and the Eastern Cooperative Oncology Group (ECOG) performance status (PS) of all patients was 0–1. The median survival time (MST) and median PFS were 20.4 [95% confidence interval (CI) 10.3–36.8] and 13.5 (95% CI 6.4–20.3) months, respectively, and the 1-year OS and PFS rates were 80.0% (95% CI 50–93.1%) and 66.7% (95% CI 37.5–84.6%), respectively. The median LRPFS and median DMFS were 15.6 (95% CI 6.4–36.8) and 14.9 (95% CI 7.0–20.5) months, respectively, and the 1-year LRPFS and DMFS rates were 73.3% (95% CI 43.6–89.1%) and 66.7% (95% CI 37.5–84.6%), respectively. Non-haematologic grade 3 toxicity was observed in three cases, of which only one was induced by radiotherapy, whereas grade 4–5 non-haematologic acute or late toxicities were not observed. The OS and PFS of elderly patients with LAPC treated using hypofractionated IMRT with concurrent gemcitabine were favourable and without the occurrence of severe toxicity. This treatment strategy is feasible and promising for elderly LAPC patients with good PS.
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DOI：
10.1016/j.ijrobp.2009.06.020
发表时间：
2010-07-15
影响因子：
7
作者：
Miyamoto, David T.;Mamon, Harvey J.;Hong, Theodore S.
通讯作者：
Hong, Theodore S.
影响因子：
2.6
作者：
De Felice, Francesca;Benevento, Ilaria;Tombolini, Vincenzo
通讯作者：
Tombolini, Vincenzo
影响因子：
45.3
作者：
Krzyzanowska, MK;Weeks, JC;Earle, CC
通讯作者：
Earle, CC
DOI：
10.1016/j.ijrobp.2015.12.003
发表时间：
2016-03-15
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Krishnan S;Chadha AS;Suh Y;Chen HC;Rao A;Das P;Minsky BD;Mahmood U;Delclos ME;Sawakuchi GO;Beddar S;Katz MH;Fleming JB;Javle MM;Varadhachary GR;Wolff RA;Crane CH
通讯作者：
Crane CH
影响因子：
4.3
作者：
Higuera, Oliver;Ghanem, Ismael;Feliu, Jaime
通讯作者：
Feliu, Jaime