Pancreatic cancer management is challenging in part due to the majority of cases being unresectable at presentation, and the role of conventionally radiotherapy is frequently debated in this setting. [1] Pancreas Stereotactic Body Radiation Therapy (SBRT) is an emerging local treatment option for patients with unresectable disease, with further trials looking into its role in borderline resectable (BRPC) and locally advanced (LAPC) disease states. [2] We aim to report on the clinical outcomes, with a focus on patient-reported outcomes, following pancreas SBRT at our institution.

Eleven patients with pancreatic cancers including BRPC/LAPC who were treated with SBRT in 2019 were included. Dose prescriptions ranged from 32 to 40Gy in 4-5 fractions. Target volume delineation and simulation technique were performed as per the consensus reached by the Australasian Gastrointestinal Trials Group (AGITG) and Trans-Tasman Radiation Oncology Group (TROG) for pancreatic SBRT. [3] Toxicity and patient reported outcomes were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) criteria, European Organisation for Research and Treatment of Cancer Quality...

All patients had pancreatic adenocarcinoma except one who had pancreatic neuroendocrine tumour. Median follow-up was 5.8 months (1.2 – 20.5). Median age of included patients was 66 years. Seven (64%) patients had passed away at last follow-up, four from distant disease progression, one from locoregional progression, one from biliary sepsis (recurrent cholecystits), and one following non-treatment-related recurrent falls. Local disease response: Ten patients (91%) Local progression: Four patients (36%) at 2.5, 4, 7 and 15 months respectively, only one of whom had isolated local progression....

SBRT for pancreatic cancer is quite well tolerated with an acceptable toxicity rate. Our toxicity/safety data is in keeping with the existing literature. [4] Our experience outlines the potential of SBRT application in pancreatic tumours other than adenocarinoma, and possibly expanding the indications beyond local control, as it may have a role in the neoadjuvant setting for BRPC. Further large cohort prospective studies would be beneficial to assess the long term efficacy, local control, survival rates, and possibly expanding the indications of SBRT in the...

1. Hammel P, Huguet F, Van Laethem J, et al. Effect of chemoradiotherapy vs chemotherapy on survival in patients with locally advance pancreatic cancer controlled after 4 months of gemcitabine with or without erlotinib: the LAP07 randomized clinical trial. JAMA 2016; 315(17): 1844-1853. 2. Petrelli F, Comito T, Ghidini A. et al. Stereotactic body radiation therapy for locally advanced pancreatic cancer: A systemic review and pooled analysis of 19 trials. International Journal of Radiation Oncology, Biology, Physics 2017; 97:313–322. 3.Oar A, Lee M, Le H,...