Evidence map›Paper›PMID 33001271›Full record

ArticleJournal of cancer research and clinical oncology2021

Hypofractionated sequential radiotherapy boost: a promising strategy in inoperable locally advanced pancreatic cancer patients.

Gian Carlo Mattiucci, Luca Boldrini, Alessia Nardangeli, Andrea D'Aviero, Milly Buwenge, Francesco Cellini, Francesco Deodato, Nicola Dinapoli, Vincenzo Frascino, Gabriella Macchia and 2 more

Erratum issuedOpen access · greenAbstract read
In one paragraph

Article in Journal of cancer research and clinical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 42% of its field
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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Gian Carlo MattiucciUniversità Cattolica del Sacro Cuore, Roma, Italy.
Luca BoldriniUniversità Cattolica del Sacro Cuore, Roma, Italy.
Alessia NardangeliUOC Radioterapia Oncologica, Dipartimento Di Diagnostica Per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy.
Andrea D'AvieroUniversità Cattolica del Sacro Cuore, Roma, Italy. andreadav89@gmail.com.ORCID http://orcid.org/0000-0002-9194-620X
Milly BuwengeRadiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
Francesco CelliniUOC Radioterapia Oncologica, Dipartimento Di Diagnostica Per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy.
Francesco DeodatoUnità Operativa Di Radioterapia, Gemelli Molise Hospital, Campobasso, Italy.
Nicola DinapoliUOC Radioterapia Oncologica, Dipartimento Di Diagnostica Per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy.
Vincenzo FrascinoUOC Radioterapia Oncologica, Dipartimento Di Diagnostica Per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy.
Gabriella MacchiaUnità Operativa Di Radioterapia, Gemelli Molise Hospital, Campobasso, Italy.
Alessio Giuseppe MorgantiRadiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
Vincenzo ValentiniUniversità Cattolica del Sacro Cuore, Roma, Italy.
Agostino Gemelli University Polyclinic · ITUniversità Cattolica del Sacro Cuore · ITIRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola · ITUniversity of Molise · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate the potential benefits of a hypofractionated radiotherapy boost (HRB) after chemotherapy (CT) and concomitant chemoradiotherapy (CRT) in locally advanced pancreatic cancer (LAPC) patients. Primary endpoints were early and late toxicity, local control (LC) and pain-free progression (PFP) assessment. Two-years overall survival (OS), metastasis-free survival (MFS) and disease-free survival (DFS) were secondary endpoints. MATERIALS AND

methodsPatients (pts) affected by unresectable non-metastatic LAPC, previously treated with CT and CRT in upfront or sandwich setting, were selected for sequential HRB. Total prescribed dose was 30 Gy in 5 fractions (fr) to pancreatic primary lesion. Dose de-escalation was allowed in case of failure in respecting organs at risk constraints. Early and late toxicity were assessed according to CTCAE v.4.0 classification. The Kersh-Hazra scale was used for pain assessment. Local Control, PFP, MFS and DFS were calculated from the date of HRB to the date of relapse or the date of the last follow-up.

resultsThirty-one pts affected by unresectable, non-metastatic LAPC were consecutively enrolled from November 2004 to October 2019. All pts completed the planned HRB. Total delivered dose varied according to duodenal dose constraint: 20 Gy in 5 fr (N: 6; 19.4%), 20 Gy in 4 fr (N: 5; 16.2%), 25 Gy in 5 fr (N: 18; 58.0%) and 30 Gy in 6 fr (N: 2; 6.4%). Early and late toxicity were assessed in all pts: no Grade 3 or 4 acute gastrointestinal toxicity and no late gastrointestinal complications occurred. Median LC was 19 months (range 1-156) and 1- and 2-year PFP were 85% and 62.7%, respectively (median 28 months; range 2-139). According to the Kersh-Hazra scale, four pts had a Grade 3 and four pts had a Grade 1 abdominal pain before HRB. At the last follow-up only 3/31 pts had residual Grade 1 abdominal pain.Median MFS was 18 months (range 1-139). The 2-year OS after HRB was 57.4%, while 2-year OS from diagnosis was 77.3%.

conclusionTreatment intensification with hypofractionated radiotherapy boost is well tolerated in pts affected by unresectable LAPC previously treated with CT/CRT. Its rates of local and pain control are encouraging, supporting its introduction in clinical practice. Timing, schedule and dose of HRB need to be further investigated to personalize therapy and optimize clinical advantages.

Indexed as

AgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCapecitabineChemoradiotherapyDeoxycytidineDisease-Free SurvivalFemaleFluorouracilGemcitabineHumansIrinotecanLeucovorinMaleMiddle AgedOxaliplatinCapecitabineDeoxycytidineFluorouracilfolfirinoxGemcitabineIrinotecanLeucovorinOxaliplatinHypofractionationLocally advanced pancreatic adenocarcinomaRadiotherapy boost

Identifiers

PMID33001271
PMCPMC11802087
OpenAlexW3091276214

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.