New options when an old enemy returns

Sep 21, 2008

Pancreatic cancer is one of the most challenging malignancies to treat, and recurrence is common, even after initial treatment with surgery and radiation. When the cancer does return, treatment options are often limited to chemotherapy, but researchers at Georgetown's Lombardi Comprehensive Cancer Center are utilizing the precision allowed by CyberKnife® to see if radiosurgery is a viable treatment option in select patients.

"When treating recurrent pancreatic tumors, there are a number of factors to evaluate before we can consider radiosurgery as an additional treatment option," explains Christopher Lominska, M.D., lead author of the study and a resident in radiation medicine at Georgetown's Lombardi Comprehensive Cancer Center. "First, treatment must be safe, which is demonstrated in this study. We also designed a treatment that can be delivered in a short period of time -- a critically important quality-of-life factor in this patient population." The results of the study were presented today at the 50th annual meeting of the American Society for Therapeutic and Radiology Oncology (ASTRO) in Boston.

For the study, Lominska and his colleagues evaluated the safety of radiosurgery using CyberKnife® by reviewing the records of patients treated for pancreatic cancer at Georgetown from June 2002 through July 2007. Twenty-eight patients were treated for locally recurrent disease, 20 of whom had had prior chemotherapy and conventional radiation, and eight of whom had had prior surgery as well as radiation and chemotherapy. Disease recurrence was visualized with CT or PET/CT imaging.

The median age of the patients was 63 years old. Follow-up was available on 24 of 28 patients (patients lost to follow-up were assumed deceased). Median survival from the date of radiosurgery treatment was 5.3 months (range 1-27 months). Seven (7) patients (25 percent) lived more than 8 months after treatment.

"We found an acceptable safety profile for those receiving radiosurgery," says Lominska. "These patients had received full doses of conventional radiation therapy prior to their radiation treatment, so this speaks to the very high level of precision of the CyberKnife® -- that we were able to give them more radiation safely. It's also worth noting that treatment was delivered in only a week allowing patients to resume systemic chemotherapy with minimal interruption."

Lominska says only two patients experienced serious GI toxicity (one peripancreatic abscess, one bowel obstruction) after being treated with three sessions of radiosurgery. (Five sessions of daily treatment are now commonly given with the belief that this is better tolerated.) Review of radiographic studies revealed local control in 6 patients, local control with distant progression in 6 patients, and local and distant progression in two patients with no follow-up imaging available on the remaining patients. As of March 2008, 26/28 patients have died. The two surviving patients remain locally controlled without evidence of distant disease on follow-up of three and 8 months.

Lominska says the preliminary survival trends look good, but are not conclusive until more studies are designed to evaluate if radiosurgery with CyberKnife can extend survival when compared with usual care.

Source: Georgetown University

Explore further: No increased risk of second cancers with radiotx in pelvic CA

add to favorites email to friend print save as pdf

Related Stories

Keep dogs and cats safe during winter

20 hours ago

(HealthDay)—Winter can be tough on dogs and cats, but there are a number of safe and effective ways you can help them get through the cold season, an expert says.

N. Korea suffers another Internet shutdown

20 hours ago

North Korea suffered an Internet shutdown for at least two hours on Saturday, Chinese state-media and cyber experts said, after Pyongyang blamed Washington for an online blackout earlier this week.

Recommended for you

Scientists zero in on how lung cancer spreads

Dec 24, 2014

Cancer Research UK scientists have taken microscopic images revealing that the protein ties tethering cells together are severed in lung cancer cells - meaning they can break loose and spread, according to ...

Scientists identify rare cancer's genetic pathways

Dec 24, 2014

An international research team, including four Simon Fraser University scientists, has identified the "mutational landscape" of intrahepatic cholangiocarcinoma (ICC), a rare, highly fatal form of liver cancer that disproportionately ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.