AUTHOR=Almog Galit , Pfeffer Raphael M. , Zalmanov Svetlana , Grinberg Vladislav , Lipsky Yoav , Chernomordikov Elena , Levin Daphne , Apter Sara , Arsenault Orit , Epstein Dan , Tamimi Qusai , Hod Keren , Limon Dror , Golan Talia , Ben-Aharon Irit , Lawrence Yaacov Richard , Ben-David Merav Akiva 

TITLE=Pancreatic cancer outcome—local treatment with radiation using MRI-LINAC

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1289919

DOI=10.3389/fonc.2023.1289919

ISSN=2234-943X

ABSTRACT=No patient reported grade ≥2 acute GI toxicity. All previously irradiated patients reported only low-grade toxicities during RT. Forty-eight patients (88.9%) were available for evaluation. Complete local control was achieved in 21.7% (10 patients) for a median of 9 months (2.8-28.8), three had later local progression. Eight patients had regional or marginal recurrence. Six-month and 12-month OS were 75.0% and 52.1%, respectively. Apart from mild diarrhea 1-3 months after SMART and general fatigue, there were no significant differences in toxicity and outcomes between post-pancreatectomy and inoperable groups.SMART allows safe delivery of an ablative dose of radiotherapy, with minimal treatment-related toxicity, even in previously resected or irradiated patients. In this real-world cohort, local control with complete response was achieved by 20% of the patients. Further studies are needed to evaluate long-term outcome and late toxicity.