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Contemporary Oncology/Współczesna Onkologia
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1/2024
vol. 28
 
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abstract:
Original paper

Combination of modified FOLFIRINOX with stereotactic body radiotherapy as an induction therapy for locally advanced pancreatic adenocarcinoma – a prospective single-arm study

Michał Piątek
1, 2
,
Michał Bieńkowski
3
,
Katarzyna Kuśnierz
4
,
Joanna Pilch-Kowalczyk
5
,
Dorota Imielska-Zdunek
6
,
Sławomir Mrowiec
4
,
Paweł Lampe
4
,
Barbara Radecka
2
,
Sergiusz Nawrocki
7, 8

  1. Department of Oncology, Medical University of Silesia, Katowice, Poland
  2. Department of Oncology, Institute of Medical Sciences, University of Opole, Opole, Poland
  3. Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland
  4. Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland
  5. Department of Radiology and Nuclear Medicine, Medical University of Silesia, Katowice, Poland
  6. Radiotherapy Division, prof. K. Gibiński Memorial University Clinical Centre, Silesian Medical University, Katowice, Poland
  7. Department of Radiotherapy, Medical University of Silesia, Katowice, Poland
  8. Oncology Department, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
Contemp Oncol (Pozn) 2024; 28 (1): 15–30
DOI: https://doi.org/10.5114/wo.2024.137760
Online publish date: 2024/03/28
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Introduction:
Radical resection is the only potentially curative treatment for pancreatic adenocarcinoma; however, only a minor fraction of patients are eligible for resection. Induction therapy may be offered to patients, but the response rate in cases with significant vascular involvement is limited. This study aimed to evaluate the efficacy and safety of modified of FOLFIRINOX chemotherapy (mFFX) + stereotactic body radiotherapy (SBRT) in combination as induction therapy for locally advanced pancreatic carcinoma. The primary endpoints were the resection rate and one-year overall survival (OS). The secondary endpoints were progression-free survival (PFS), toxicity, and quality of live (QoL).

Material and methods:
Thirty patients with locally advanced pancreatic adenocarcinoma were treated with 6 cycles of mFFX, followed by SBRT and additional 3 cycles of mFFX. The response was measured prior to SBRT and after regimen completion. In the absence of disease progression, the patients were referred for surgery. The patients were requested to complete quality of life questionnaires (QLQ)-C30 and QLQ-PAN26 questionnaires biweekly.

Results:
On the first evaluation, disease control was noted in 26 (86.7%) patients. Stereotactic body radiotherapy was performed in 20 patients. Twelve patients underwent laparotomy, with radical resection possible in 3 cases. The one-year OS rate was 63.3%. Overall, 11 grade ≥ 3 adverse events were noted. No deterioration in the overall QoL was observed. The median PFS was 7.53 months.

Conclusions:
The expected resection rate of ≥ 30% was not achieved. However, the combination was associated with good local control, low adverse event rate, and good QoL, which advocate its further investigation in this clinical situation.

keywords:

chemotherapy, health- related quality of life, neoadjuvant therapy, pancreatic ductal carcinoma, stereotactic body radiation therapy
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