Targeted Radiation Effective, Safe for Senior
Citizens with Pancreatic Cancer
Not a cure but Stereotactic body radiotherapy (SBRT)
extends life for elderly by months; minimal side-effects even when
burdened by other health problems; two patients lived almost two years -
see video in story
Sep. 24, 2013 Effective therapy for pancreatic
cancer the deadliest of cancers is a major pursuit in healthcare
research. It is especially challenging when treating the disease in
elderly patients, who often have other health problems that complicate
successful treatment. Now, researchers at Henry Ford Hospital in Detroit
have declared a highly targeted cancer radiation may offer safe and
effective treatment for the elderly unable to undergo surgery or
combined chemotherapy and radiation therapy.
Called stereotactic body radiotherapy (SBRT), the
study finds patients lived, on average, six to seven months longer
following treatment with minimal side-effects even when they had other
severe comorbidities such as chronic obstructive pulmonary disease (COPD),
heart disease and diabetes.
Two of the patients in the study lived nearly two
Elderly individuals, those ages 75 and older,
account for approximately 40 percent of patients diagnosed with
pancreatic cancer, says study lead author Raphael Yechieli, M.D., with
the Department of Radiation Oncology at Henry Ford Hospital.
About Stereotactic Body Radiation Therapy (SBRT) at
UCLA was the first in the U.S. to use of focal high
dose radiotherapy to eradicate tumors over 25 years ago, and one of the
pioneers in the development of linear accelerators used to deliver
stereotactic radiosurgery (3-dimensional image-guided focal radiation)
to ablate tumors in the brain.
Stereotactic Body Radiation Therapy (SBRT) is a
treatment procedure similar to central nervous system (CNS) stereotactic
radiosurgery, except that it deals with tumors outside of the CNS. A
stereotactic radiation treatment for the body means that a specially
designed coordinate-system is used for the exact localization of the
tumors in the body in order to treat it with limited but highly precise
Today, UCLA Radiation Oncologists
continue to be leaders in the use of state of the art radiation
technologies for the treatment of cancer. UCLA physicians are the first
in the world to have pioneered the use of
stereotactic radiosurgery techniques for the treatment of prostate
cancer and were the first to publish results from this
UCLA now has an active clinical program using
stereotactic body radiotherapy (abbreviated SBRT) to treat prostate
These patients are too ill to receive any other
treatment, but with stereotactic body radiotherapy were able to deliver
a safe and effective treatment in two weeks that can provide them with a
substantial quality of life with minimal side effects.
The study was presented at the 55nd annual American
Society for Radiation Oncology (ASTRO) meeting in Atlanta.
In 2013, there will be an estimated 45,220 new
cases of pancreatic cancer, and approximately 38,460 will die from the
disease, according to the National Cancer Institute. Risk factors for
pancreatic cancer include smoking, diabetes, obesity, family history of
the disease and pancreatitis. Most people diagnosed with the disease are
older than 65.
Surgery is the only known cure for resectable
pancreatic cancer, where the cancer is localized to the pancreas and
hasn't spread. It is estimated that only 20 percent of pancreatic cancer
patients have their tumors present with localized disease amendable to
A select number of those patients, however, are not
candidates for surgery due to having other co-morbidities such as COPD,
heart disease and diabetes. This leaves only chemotherapy and radiation,
or a combination of the two, available for treatment.
But for a large portion of elderly patients with
localized pancreatic cancer even chemotherapy and radiation therapy are
The Henry Ford study looked to determine if SBRT a method of giving
radiation that can be highly targeted to the tumor, sparing the normal
tissue around it was a viable option for this group of patients. SBRT
provides a higher dose of radiation, meaning patients have fewer
treatments. In this case, treatment averaged two weeks.
The study included 20 patients with a median age of
83, all of whom were medically unable to tolerate surgery or combined
chemo-radiation therapy. The majority of patients in the study (90
percent) received SBRT treatment at the time of diagnosis.
Seven patients reported side-effects from
treatment: nausea, vomiting and fatigue.
Among the patients: 13 had a recurrence of cancer;
nine had cancer spread from the original tumor to distant organs or
distant lymph nodes.
Median overall survival was 6.7 months, and median
recurrence-free survival was 8.1 months. At six months post-treatment,
61 percent of patients were alive; two patients in the study survived
nearly two years.
National trends tell us that very few patients
over the age of 75 are getting any treatment at all for pancreatic
cancer due to comorbidity risks, notes Dr. Yechieli. So we want to
push the envelope to give them a treatment option that, while not a
cure, is short, effective and safe, and has the potential to give them a
good quality of life.
The next step in this research, Dr. Yechieli says,
is to closely follow patients after SBRT and get their direct feedback
to measure post-treatment quality of life.