Evidence map›Paper›PMID 41644009›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2026

Neoadjuvant stereotactic body vs conventionally fractionated radiation therapy for borderline resectable and locally advanced pancreatic cancer: a propensity score-matched analysis.

Takayuki Shimizu, Serena Zheng, Shimpei Maeda, Jason Link, Aletta Deranteriassian, Alykhan Premji, Johathan King, Mark Girgis, Oscar Joe Hines, Zev Wainberg and 10 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

20 authors.

Takayuki ShimizuDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States; Department of Hepato-Biliary-Pancreatic Surgery, Dokkyo Medical University, Mibu, Japan.
Serena ZhengDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Shimpei MaedaDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Jason LinkDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Aletta DeranteriassianDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Alykhan PremjiDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Johathan KingDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Mark GirgisDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Oscar Joe HinesDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Zev WainbergDepartment of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Ann RaldowDepartment of Radiation Oncology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
Jin HeDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.
William BurnsDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Amol NarangDepartment of Radiation Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Motaz QadanDepartment of Surgery, Massachusetts General Hospital, Boston, MA, United States.
Carlos Fernandez-Del CastilloDepartment of Surgery, Massachusetts General Hospital, Boston, MA, United States.
Keith D LillemoeDepartment of Surgery, Massachusetts General Hospital, Boston, MA, United States.
Jennifer WoDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States.
Theodore HongDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States.
Timothy R DonahueDepartment of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States. Electronic address: tdonahue@mednet.ucla.edu.

Funding

UCLA Surgeon-Scientist Basic Cancer Research Training Program (UCLA Surgeon-Scientist BCRTP)T32CA302559 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Vatche Agopian, MANUEL L PENICHET · 2025 to 2026
$544k
NCI NIH HHS T32 CA302559
6 · The paper itself

Abstract

backgroundStereotactic body radiation therapy (SBRT) is increasingly used in neoadjuvant chemoradiotherapy (NCRT) for borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PC), but head-to-head data on SBRT vs conventionally fractionated radiation therapy (CFRT) remain limited. We compared clinical and pathological outcomes of SBRT vs CFRT in BR/LA PC.

methodsWe retrospectively analyzed 312 patients with BR/LA PC who received NCRT followed by margin-negative (R0)/margin-positive surgery at 3 high-volume academic centers (2011-2021). To reduce selection bias, 1:1 propensity score matching (PSM) was applied based on baseline clinical variables. The primary outcome was overall survival (OS), and the secondary outcome was clinical and pathological response to NCRT.

resultsOf 312 patients, 177 (56.7%) received SBRT and 135 (43.3%) received CFRT. Before PSM, significant differences were observed in patient age, neoadjuvant chemotherapy regimen, and duration of the preoperative interval. After PSM, 180 patients were matched, with no significant differences in pretreatment variables between groups. Clinical and pathological outcomes were similar between the matched cohorts, including complete/near-complete pathological response rates (36.7% vs 45.6%; P =.56), node-positive disease (32.2% vs 36.7%; P =.53), and R0 resection rates (80.0% vs 82.2%; P =.70). The median OS was not significantly different (27.2 vs 40.6 months; P =.70). Patients in the SBRT cohort were more likely to receive adjuvant therapy than those in the CFRT cohort (60.0% vs 38.9%; P =.007). In subgroup analyses restricted to patients treated with neoadjuvant FOLFIRINOX (FFX), SBRT was associated with a significantly longer OS among those presenting with markedly elevated pretreatment carbohydrate antigen 19-9 (CA19-9) levels (≥1500 U/mL) (29.8 vs 12.1 months; P =.02).

conclusionNeoadjuvant SBRT achieves oncologic outcomes comparable with CFRT in BR/LA PC and is associated with greater adjuvant therapy use. A potential survival signal for SBRT in patients receiving FFX with CA19-9 of ≥1500 U/mL is hypothesis generating and warrants validation and formal interaction testing.

Indexed as

Carcinoma, Pancreatic DuctalNeoadjuvant TherapyPancreatic NeoplasmsRadiosurgeryAgedAntineoplastic Combined Chemotherapy ProtocolsDose Fractionation, RadiationFemaleFluorouracilHumansIrinotecanLeucovorinMaleMiddle AgedOxaliplatinPropensity ScoreFluorouracilIrinotecanLeucovorinOxaliplatinNeoadjuvant therapy

Identifiers

PMID41644009
PMCPMC13095238

What OpenQuestion holds

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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.