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• W2758942403 abstract "The purpose of this study is to determine if increasing biologically effective dose (BED) with SBRT is correlated with improved local control (LC) or toxicities in patients with locally advanced or borderline resectable pancreatic cancer. A meta-analysis was performed of 15 studies across 12 institutions in 6 countries, treated with definitive SBRT, from 2000 to 2014, excluding M+ patients and those receiving surgery. BEDs were calculated with a/b of 10 (i.e. BED10) for LC and early toxicity, and 3 (i.e. BED3) for late toxicity. A random effects model was used to characterize LC and grade 3/4 toxicities by BED, which was chosen to allow for effect size variations between the different study populations. The proportion of patients in the respective study to the total number of patients was used to estimate effect size. A limitation of this analysis was an inability to include dose-painting regimens. There were 520 patients included, median follow up time was 9.1 months (range: 4.5 – 24.0 mos), median patient age was 67 years, and 81% of patients had unresectable disease. Gemcitabine-based pre-SBRT chemotherapy was administered in 54.6% of patients. The median dose was 30 Gy (interquartile range: 24 Gy – 33 Gy), and the most common regimen was 30 Gy/5 fractions. The median survival time was 13.3 mos (range: 6.2 – 20 mos) and median 1-year overall survival was 53.9%. The likelihood of outcome and toxicity with its corresponding 95% confidence interval (CI) are shown in the Table. There was no significant difference in LC rates at one year between the BED10 < 70 Gy vs >/= 70 Gy groups, random effects estimate 0.66 (0.48-0.82) vs 0.79 (0.62-0.92), respectively. There was no significant difference in early toxicity between the BED10 < 70 Gy vs. >/= 70 Gy groups, random effects estimate 0.01 (0.00-0.06) vs 0.04 (0.00-0.15), respectively. Given the dose distribution across studies, three intervals were used to characterize BED3. There was no significant difference in late toxicity among those receiving BED3< 100 Gy, 100–200 Gy, or >/= 200 Gy.Tabled 1Abstract 2489; Table Outcomes in pancreatic cancer treated with SBRT1-Year Local Control(a/b = 10)Early Toxicity(a/b = 10)Late Toxicity(a/b = 3)< 70 Gy>/= 70 Gy< 70 Gy>/= 70 Gy< 100 Gy100-200 Gy>/= 200 Gy0.66(0.48; 0.82)0.79(0.62; 0.92)0.01(0.00; 0.06)0.04(0.00; 0.15)0.08(0.01; 0.21)0.02(0.00; 0.05)0.01(0.00; 0.06)Note: Values are reported as estimated fraction under random-effects model with 95% CI. Open table in a new tab Note: Values are reported as estimated fraction under random-effects model with 95% CI. Increasing BED10 beyond 70 Gy was not associated with increased rates of LC or acute toxicity. Increasing BED3beyond 100 Gy was not associated with increased rates of late toxicity." @default.
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• W2758942403 date "2017-10-01" @default.
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• W2758942403 title "The Effect of Increasing Biologically Effective Dose in Stereotactic Body Radiation Therapy for Locally Advanced and Borderline Resectable Pancreatic Cancer: A Meta-analysis" @default.
• W2758942403 doi "https://doi.org/10.1016/j.ijrobp.2017.06.1089" @default.
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