ArticleBMC cancer2026
A retrospective analysis of Selective Internal Radiation Therapy (SIRT) and chemotherapy for metastatic pancreatic adenocarcinoma.
Article in BMC cancer, 2026. 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
backgroundPancreatic ductal adenocarcinoma (PDAC) is a major cause of cancer-related deaths in Australia, with a 5-year survival rate of less than 13%. The liver is the most common site of PDAC metastasis, and is observed in over 50% of cases. Standard chemotherapy, including regimens such as FOLFIRINOX or nab-paclitaxel plus gemcitabine, offer limited survival benefits, with median survival rates typically below one year. Selective internal radiation therapy (SIRT) with Yttrium-90 (90Y) microspheres is used to target liver metastases, but the optimal chemotherapy companion for SIRT in metastatic PDAC remains unknown.
methodsWe conducted a retrospective audit of 32 patients with metastatic PDAC treated with SIRT and chemotherapy, and evaluated the clinical outcomes associated with platinum-based versus non-platinum-based regimens.
resultsPatients who received platinum-based chemotherapy alongside SIRT had a median PFS of 10 months, compared to 2 months in those treated with non-platinum-based regimens. Stratified analysis revealed that patients receiving platinum-based chemotherapy in the first-line setting achieved a median post-SIRT survival of 16 months, compared to 4 months for those treated in later lines. For non-platinum-based regimens, median post-SIRT survival was 9 months in the first-line and 6 months in later lines. Median OS from Stage IV diagnosis was 17 months for patients with liver-only metastases and 15 months for those with additional extra-hepatic disease, suggesting that liver disease burden remains a dominant driver of outcomes.
conclusionsThese findings describe survival outcomes among patients treated with SIRT and chemotherapy for metastatic PDAC in a real-world setting. Longer observed survival was seen in patients who received platinum-based chemotherapy alongside SIRT, particularly in the first-line setting. Given the descriptive design and small sample size, these findings should be interpreted as hypothesis-generating and may inform future prospective evaluation of SIRT-chemotherapy combinations.
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