Evidence map›Paper›PMID 24772334›Full record

ArticleJournal of gastrointestinal oncology2014

The influence of radiation therapy dose escalation on overall survival in unresectable pancreatic adenocarcinoma.

William A Hall, Lauren E Colbert, Dana Nickleach, Jeffrey Switchenko, Yuan Liu, Theresa Gillespie, Joseph Lipscomb, Claire Hardy, David A Kooby, Roshan S Prabhu and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastrointestinal oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

William A Hall1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Lauren E Colbert1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Dana Nickleach1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Jeffrey Switchenko1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Yuan Liu1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Theresa Gillespie1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Joseph Lipscomb1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Claire Hardy1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
David A Kooby1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Roshan S Prabhu1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
John Kauh1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Jerome C Landry1 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 2 Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, GA, USA ; 3 Department of Surgery and Winship Cancer Institute, Emory University, Atlanta, GA, USA ; 4 Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA ; 5 Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, USA ; 6 Department of Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.

Funding

Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI MADHAV V DHODAPKAR · 2009 to 2026
$47.5M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalTL1TR000456 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$1.2M
NCATS NIH HHS TL1 TR000456NCATS NIH HHS UL1 TR000454NCI NIH HHS P30 CA138292
6 · The paper itself

Abstract

purposeRadiation therapy (RT) dose escalation in unresectable pancreatic adenocarcinoma (PAC) remains investigational. We examined the association between total RT dose and overall survival (OS) in patients with unresectable PAC. METHODS AND MATERIALS: National cancer data base (NCDB) data were obtained for patients who underwent definitive chemotherapy and RT (chemo-RT) for unresectable PAC. Univariate (UV) and multivariate (MV) survival analysis were performed along with Kaplan-Meier (KM) estimates for incremental RT dose levels.

resultsA total of 977 analyzable patients met inclusion criteria. Median tumor size was 4.0 cm (0.3-40 cm) and median RT dose was 45 Gy. Median OS was 10 months (95% CI, 9-10 months). On MV analysis RT dose <30 Gy [HR, 2.38 (95% CI, 1.85-3.07); P<0.001] and RT dose ≥30 to <40 Gy [HR, 1.41 (95% CI, 1.04-1.91); P=0.026] were associated with lower OS when compared with dose ≥55 Gy. Patients receiving RT doses from 40 to <45, 45 to <50, 50 to <55, and ≥55 Gy did not differ in OS.

conclusionsLack of benefit to OS with conventionally delivered RT above 40 Gy is shown. Optimal RT dose escalation methods in unresectable PAC remain an important subject for investigation in prospective clinical trials.

Indexed as

dose response pancreatic cancerPAC and intensity modulated radiation therapy (IMRT)PAC and radiation therapy (RT)radiation dose escalation in pancreatic adenocarcinoma (PAC)Radiation dose escalation pancreatic cancerRT dose in unresectable pancreatic cancerunresectable pancreatic cancer

Identifiers

PMID24772334
PMCPMC3999628

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.