Cancer Management and Research (Jul 2022)

Stereotactic Body Radiotherapy for Locally Advanced Pancreatic Cancer Using Optical Surface Management System – AlignRT as an Optical Body Surface Motion Management in Deep Breath Hold Patients: Results from a Single-Arm Retrospective Study

  • Kaučić H,
  • Kosmina D,
  • Schwarz D,
  • Mack A,
  • Čehobašić A,
  • Leipold V,
  • Avdićević A,
  • Mlinarić M,
  • Lekić M,
  • Schwarz K,
  • Banović M

Journal volume & issue
Vol. Volume 14
pp. 2161 – 2172

Abstract

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Hrvoje Kaučić,1,2 Domagoj Kosmina,3 Dragan Schwarz,4– 6 Andreas Mack,7 Adlan Čehobašić,2,3 Vanda Leipold,2,3 Asmir Avdićević,1 Mihaela Mlinarić,3 Matea Lekić,1 Karla Schwarz,8 Marija Banović9 1Department of Radiosurgery and Radiotherapy, Special Hospital Radiochirurgia Zagreb, Sveta Nedelja, Croatia; 2University Josip Juraj Strossmayer in Osijek – Medical Faculty Osijek, Osijek, Croatia; 3Department of Medical Physics, Special Hospital Radiochirurgia Zagreb, Sveta Nedelja, Croatia; 4Department of Surgery, Special Hospital Radiochirurgia Zagreb, Sveta Nedelja, Croatia; 5Department of Surgery, Medical Faculty of University in Rijeka, Rijeka, Croatia; 6Department of Surgery, University Josip Juraj Strossmayer in Osijek – Faculty of Dental medicine and Health, Osijek, Croatia; 7Swiss NeuroRadiosurgery Center, Swiss Clinical NeuroScience Institute, Zürich, Switzerland; 8University of Zagreb, Medical Faculty, Zagreb, Croatia; 9Department of Endocrinology, Polyclinic Leptir, Zagreb, CroatiaCorrespondence: Hrvoje Kaučić, Specijalna Bolnica Radiochirurgia Zagreb, Ulica Dr. Franje Tuđmana 4, Sveta Nedelja, 10431, Croatia, Tel +385 91 5622 191, Email [email protected]: To assess the efficacy and safety of stereotactic body radiotherapy for patients with unresectable, locally advanced pancreatic cancer using Optical Surface Management System – AlignRT (OSMS-AlignRT) as an optical body surface motion management in deep breath hold.Patients and Methods: Forty-five patients diagnosed with locally advanced pancreatic cancer were treated with stereotactic body radiotherapy in 3 or 5 fractions, and received varying BED10 (median 79.5 Gy) from April 2017 to December 2020. All patients were treated in deep breath hold with OSMS-AlignRT used as optical body surface motion management. Thirty-three patients received systemic treatment before and/or after stereotactic body radiotherapy, and twelve patients received no systemic treatment. In this retrospective, observational, single-arm study, primary endpoints were overall survival and freedom from local progression (ie, local control). Secondary endpoints were progression-free survival and toxicity. Actuarial survival analysis and univariate analysis were investigated.Results: Data from forty-five patients were analyzed. Median follow-up was 15 months. One-year freedom from local progression and survival were 95.5% and 71.1%, respectively. Median progression-free survival was 14 months. Median overall survival from diagnosis for all patients was 17 months, and 19 months for patients alive at the time of analysis. No patient had >G2 toxicity.Conclusion: Stereotactic body radiotherapy for locally advanced pancreatic cancer using OSMS-AlignRT as optical body surface motion management in deep breath hold patients is an effective and safe local treatment option, with no >G2 toxicity, and could be a promising therapeutic option with acceptable toxicity, either as a single treatment or in a multimodal regimen. OSMS-AlignRT provided accurate and reliable body surface motion management during stereotactic body radiotherapy.Keywords: AlignRT, locally advanced pancreatic cancer, Optical Surface Management System, pancreatic SBRT, surface guided radiotherapy

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