F. Sourial1, P. Shamsesfandabadi1, R. E. Wegner1, A. V. Kirichenko1, D. Monga2, N. Bahary2, S. Beriwal1, and P. B. Renz1; 1Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA, 2Allegheny Health Network Division of Medical Oncology, Pittsburgh, PA
Purpose/Objective(s): Pancreatic cancers aggressive nature and poor prognosis are often exacerbated by liver oligometastases, with standard care involving systemic chemotherapy yielding poor progression free survival outcomes (PFS). This study aims to evaluate the efficacy and safety of Stereotactic Body Radiation Therapy (SBRT) for liver oligometastases in pancreatic cancer patients. Materials/
Methods: A retrospective study with 25 patients with pancreatic cancer liver oligometastases underwent treatment with SBRT between October 2015 and June 2022. The primary endpoint was median PFS following SBRT, with secondary endpoints including survival, treatment tolerance, dosimetric parameters of organs at risk (OARs), and toxicity profiles. Patients were closely monitored through clinical assessments and serial imaging to evaluate therapeutic outcomes and adverse events. Progression was determined by radiographic criteria (RECIST v1.1), clinical progression, or death. Results: At a medium follow-up of 10.2 months, 7 of 25 patients had no evidence of progression and a median PFS of 9 months, indicative of a significant improvement compared to historical conventional chemotherapy approaches. Additionally, 6 of 25 patients were still alive at the cutoff date for primary analysis. The median OS was observed to be 12 months, suggesting the potential of SBRT in extending survival for pancreatic cancer patients with liver oligometastases. There were no grade =2 toxicity reported. Dosimetric evaluation for OARs revealed a mean liver dose of 8.8 Gy and a maximum bowel dose of 9.1 Gy. Conclusion: SBRT for liver oligometastases in pancreatic cancer patients represents a promising therapeutic strategy, offering a potential PFS and survival benefit over traditional chemotherapy regimens. Further research and larger clinical trials are warranted to validate these results and optimize treatment protocols.
