Evidence map›Paper›PMID 35142085›Full record

ArticleCancer medicine2022

High local failure rates despite high margin-negative resection rates in a cohort of borderline resectable and locally advanced pancreatic cancer patients treated with stereotactic body radiation therapy following multi-agent chemotherapy.

Colin Hill, Shuchi Sehgal, Wei Fu, Chen Hu, Abhinav Reddy, Elizabeth Thompson, Amy Hacker-Prietz, Dung Le, Ana De Jesus-Acosta, Valerie Lee and 9 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
2.3field-weighted citation impact, top 10% 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

12 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Locally Advanced Pancreas Cancer, Is There a Role for Surgery?The Surgical clinics of North America · 2024
    Review
  5. Stereotactic Body Radiation Therapy for Locally Advanced Pancreatic Cancer.Clinical and experimental gastroenterology · 2024
    Review
  6. Article
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
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

19 authors at 5 institutions in 1 country.

Colin HillDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-8226-8566
Shuchi SehgalPhiladelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.
Wei FuDepartment of Biostatistics and Bioinformatics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Chen HuDepartment of Biostatistics and Bioinformatics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Abhinav ReddyDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Elizabeth ThompsonDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Amy Hacker-PrietzDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Dung LeDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ana De Jesus-AcostaDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Valerie LeeDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Lei ZhengDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0003-4163-2541
Daniel A LaheruDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
William BurnsDepartment of Medical Oncology, The Sidney Kimmel Comprehensive Cancer Center, Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, Maryland, USA.
Matthew WeissDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Christopher WolfgangDepartment of Surgery, Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, USA.
Jin HeDepartment of Medical Oncology, The Sidney Kimmel Comprehensive Cancer Center, Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, Maryland, USA.
Joseph M HermanDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
Jeffrey MeyerDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Amol NarangDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Johns Hopkins University · USBloomberg (United States) · USHofstra University · USNew York University · USPhiladelphia College of Osteopathic Medicine · US

Funding

Transforming Human Pancreatic Cancer Into An Immunologic DiseaseP01CA247886 · NCI · JOHNS HOPKINS UNIVERSITY · PI JAFFEE, ELIZABETH M. · 2021 to 2025
$12.7M
Targeting the Immunosuppressive Tumor Microenvironment of Pancreatic Cancer with a Neoadjuvant Platform Clinical TrialR01CA197296 · NCI · JOHNS HOPKINS UNIVERSITY · PI William Reece Burns, Eric Christenson · 2015 to 2026
$5.7M
NCI NIH HHS P01 CA247886NCI NIH HHS R01 CA197296
6 · The paper itself

Abstract

backgroundStereotactic body radiation therapy (SBRT) for patients with borderline resectable and locally advanced pancreatic adenocarcinoma (BRPC/LAPC) remains controversial. Herein, we report on surgical, pathologic, and survival outcomes in BRPC/LAPC patients treated at a high-volume institution with induction chemotherapy (CTX) followed by 5-fraction SBRT.

methodsBRPC/LAPC patients treated between 2016 and 2019 were retrospectively reviewed. Surgical and pathological outcomes were descriptively characterized. Overall survival (OS) and progression-free survival (PFS) were analyzed using Cox proportional hazard regression. Locoregional failure and distant failure were analyzed with Fine-Gray competing risk model.

resultsOf 155 patients, 91 (59%) had LAPC and 64 (41%) had BRPC. Almost all were treated with induction multi-agent CTX with either FOLFIRINOX (75%) or gemcitabine and nab-paclitaxel (24%) for a median duration of 4.0 months (1-18 months). All received SBRT to a median dose of 33 Gy. Among 64 BRPC patients, 50 (78%) underwent resection, of whom 48 (96%) achieved margin-negative (R0) resection. Among 91 LAPC patients, 57 (63%) underwent resection, of whom 50 (88%) achieved R0 resection. Despite the high R0 rate, 33% of patients experienced locoregional failure, which was a component of 44% of all failures. After SBRT, median OS and PFS were 18.7 and 7.7 months, respectively. After SBRT, 1- and 2-year OS probabilities were 70% and 45%, whereas, from diagnosis, they were 93% and 51%.

conclusionsAlthough a high proportion of BRPC/LAPC patients treated with induction multi-agent CTX followed by SBRT successfully achieved R0 resection, locoregional failure remained common, highlighting the need to continue to optimize radiation delivery in this context.

Indexed as

AdenocarcinomaPancreatic NeoplasmsRadiosurgeryAntineoplastic Combined Chemotherapy ProtocolsHumansNeoadjuvant TherapyRetrospective StudiesBRPCLAPClocoregional failuremulti-agent CTXPDACSBRT

Identifiers

PMID35142085
PMCPMC8986142
OpenAlexW4211156771

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.