LAP times.

Despite widespread inclusion of SBRT as a standard option for treating locally advanced pancreatic cancer, there is fairly limited clinical trial data. Here are long-term outcomes from LAPC-1, which was a Dutch trial of SBRT for locally advanced pancreatic cancer following 8 cycles of induction FOLFIRINOX. This trial used a prescription dose of 40 Gy in 5 fractions with the goal of covering 95% of the target with 95% of the prescription dose (38 Gy). Intra-target dose heterogeneity was allowed as was to meet normal tissue constraints. They allowed a maximum bowel/stomach dose of 35 Gy in 5 fractions. Of the 50 patients initially enrolled, 39 (78%) completed chemo and moved to SBRT. Among those who underwent SBRT, median OS was 18 months and 1-year and 3-year OS rates were 77% and 13%. Local control was 81% at 1 year and 53% at 3 years. The rate of grade 3+ toxicity was 10%, and 2 patients (5%) had grade 5 GI bleeds. TBL: Long-term local control is favorable among patients who receive SBRT after FOLFIRINOX for locally advanced pancreatic cancer. | Teriaca, Radiother Oncol 2020


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