Stereotactic body radiation therapy for pancreatic cancer: evaluating its efficacy, safety, and future prospects: systematic review.
Biplab Sarkar
✦ AI-curated · Sources linked
In 30 seconds
This systematic narrative review assessed stereotactic body radiation therapy (SBRT) for locally advanced pancreatic cancer, including patients unsuitable for surgery. It included 35 studies of photon, proton, and carbon-ion treatment, with narrative synthesis and pooled estimates from recent meta-analyses. One-year local control ranged from 70% to 95% (pooled 82%), while median overall survival ranged from 13 to 20 months (pooled 16.8 months). The review reports low rates of severe toxicity, but distant progression remained common, highlighting the limits of local treatment alone.
Key findings
- One-year local control ranged 70%-95% (pooled 82%); median OS was 13-20 months (pooled 16.8 months).
- Higher biologically effective doses (BED₁₀) (>70 Gy) were associated with improved local control (HR 0.68).
- Grade ≥3 acute toxicity was 3%, and late gastrointestinal toxicity was 2%.
- Distant progression (60%) predominated despite local treatment.
Why it matters
The review suggests SBRT can provide substantial local control with relatively low reported severe toxicity in locally advanced disease. However, frequent distant progression indicates that local control does not resolve the broader risk of cancer progression. These findings help frame SBRT’s potential role within multimodal care while underscoring the need for stronger comparative evidence.
What to keep in mind
The review included heterogeneous study designs and treatments, so the authors used narrative synthesis; pooled estimates were drawn from recent meta-analyses. The abstract calls for large randomized trials.