ArticleRadiation oncology (London, England)2025
Magnetic resonance-guided online adaptive stereotactic body radiotherapy for advanced inoperable pancreatic cancer: a prospective study.
Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo assess the local control, safety, and symptom relief of magnetic resonance-guided online adaptive stereotactic body radiation therapy (MRg-oART-SBRT) combined with systemic therapy in advanced unresectable pancreatic cancer.
methodsThis single-center, open-label, prospective trial enrolled ≥ 18-year-old patients with pathologically confirmed pancreatic ductal adenocarcinoma, including locally advanced, post-recurrent, and oligometastatic cases deemed unresectable via multidisciplinary evaluation. ECOG 0–2 patients with/without prior chemotherapy received 40–50 Gy/5 fractions via 1.5T MR-linear accelerator with daily online adaptive radiotherapy. Primary endpoint was 6-month local control rate; secondary endpoints included 3-month pain relief, ≥G3 gastrointestinal toxicity within 90 days, and 6-month distant progression-free survival.
resultsFrom November 2023 to December 2024, 34 patients completed MRg-oART-SBRT. With median follow-up of 12.3 months (IQR 9.0–14.4) after radiotherapy, the 6-month and 1-year local control rate were both 80.2%. Median distant progression-free survival was 9.7 months after radiotherapy. 97% reported pain relief at 3 months after radiotherapy. Acute probably radiation-related toxicity was mild (G1–2 diarrhea 18%). Thrombocytopenia (G2–3: 18%) and palmar-plantar erythrodysesthesia (G1–2: 12%) were most common treatment-related adverse reactions.
conclusionMRg-oART-SBRT demonstrates encouraging short-term control, manageable toxicity, and survival signals in advanced pancreatic cancer. Larger multicenter trials with extended follow-up are warranted to validate long-term efficacy and clinical utility.
trial registrationThe study was registered on the Chinese Clinical Trial Registry, with the registration number ChiCTR2500096492.The retrospective registration date was January 24, 2025.
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