Strahlentherapie und Onkologie

, Volume 190, Issue 5, pp 485–490 | Cite as

Radiotherapy for patients with isolated local recurrence of primary resected pancreatic cancer

Prolonged disease-free interval associated with favorable prognosis
  • Akira NakamuraEmail author
  • Satoshi Itasaka
  • Kyoichi Takaori
  • Yoshiya Kawaguchi
  • Keiko Shibuya
  • Michio Yoshimura
  • Yukinori Matsuo
  • Takashi Mizowaki
  • Shinji Uemoto
  • Masahiro Hiraoka
Original article


Background and purpose

To evaluate the treatment outcomes of radiotherapy and prognostic factors for recurrent pancreatic cancer.

Patients and methods

The study comprised 30 patients who developed a locoregional recurrence of primarily resected pancreatic cancer and received radiotherapy between 2000 and 2013 with a median dose of 54 Gy (range, 39–60 Gy). Concurrent chemotherapy included gemcitabine for 18 patients and S-1 for seven patients. The treatment outcomes and prognostic factors were retrospectively analyzed.


The median follow-up after radiotherapy was 14.6 months. The 1-year overall survival, local control, and progression-free survival rates were 69 %, 67 %, and 32 %, respectively. The median overall survival and progression-free survival rates were 15.9 and 6.9 months, respectively. Tumor marker reduction and ≥ 50 % reduction were observed in 18 and two patients, respectively. Of the seven patients who exhibited pain symptoms, four and two patients were partly and completely relieved, respectively. Late grade 3 ileus and gastroduodenal bleeding were observed in one patient each. Among the clinicopathological factors evaluated, only a disease-free interval of greater than 18.9 months exhibited a significant association with improved overall survival (p = 0.017).


Radiotherapy for isolated locally recurrent pancreatic cancer resulted in encouraging local control, overall survival, and palliative effects with mild toxicity, particularly in patients with a prolonged disease-free interval. This treatment strategy should be prospectively evaluated.


Pancreatic cancer Isolated local recurrence Chemoradiation therapy Prognostic factor Toxicity 

Radiotherapie für Patienten mit isoliertem lokalem Rezidiv eines primär resezierten Pankreaskarzinoms

Verlängerte krankheitsfreie Zeit mit besserer Prognose assoziiert



Beurteilung strahlentherapeutischer Behandlungsergebnisse und prognostischer Faktoren bei rezidivierendem Pankreaskrebs.

Material und Methoden

In dieser Studie wurden 30 Patienten aufgenommen, bei denen es nach primär reseziertem Pankreaskrebs zu lokoregionären Rezidiven kam und die zwischen 2000 und 2013 strahlentherapeutisch mit einer mittleren Dosis von 54 Gy (Bereich 39–60 Gy) behandelt wurden. Im Rahmen der gleichzeitig durchgeführten Chemotherapie wurde bei 18 Patienten Gemcitabin und bei 7 Patienten S-1 eingesetzt. Behandlungsergebnisse und prognostische Faktoren wurden retrospektiv analysiert.


Die durchschnittliche Beobachtungszeit nach Strahlentherapie betrug 14,6 Monate. Die 1-Jahres-Gesamtüberlebensrate, die lokale Kontrolle und die progressionsfreie Überlebensrate betrugen jeweils 69 %, 67 % bzw. 32 %. Die durchschnittliche Gesamtüberlebens- und progressionsfreie Überlebensrate betrugen jeweils 15,9 bzw. 6,9 Monate. Bei 18 bzw. 2 Patienten wurden jeweils eine Reduktion der Tumormarker und eine Reduktion ≥ 50 % beobachtet. Unter den 7 Patienten mit schmerzhaften Symptomen wurden jeweils 4 und 2 teilweise bzw. vollständig von den Schmerzen befreit. Bei jeweils einem Patienten wurde verzögerter Grad-3-Ileus und gastroduodenale Blutungen beobachtet. Unter den bewerteten klinisch pathologischen Faktoren zeigte nur das krankheitsfreie Intervall > 18,9 Monate einen signifikanten Zusammenhang mit einem verbessertem Gesamtüberleben (p = 0,017).


Strahlentherapie führte bei lokal rezidivierendem Pankreaskrebs zu vielversprechender lokaler Kontrolle, Gesamtüberleben und palliativen Effekten mit milder Toxizität, insbesondere bei Patienten mit verlängertem krankheitsfreien Intervall. Diese Behandlungsstrategie sollte prospektiv ausgewertet werden.


Pankreaskrebs Isoliertes lokales Rezidiv Chemotherapie Prognostische Faktoren Toxizität 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Akira Nakamura
    • 1
    Email author
  • Satoshi Itasaka
    • 1
  • Kyoichi Takaori
    • 2
  • Yoshiya Kawaguchi
    • 2
  • Keiko Shibuya
    • 3
  • Michio Yoshimura
    • 1
  • Yukinori Matsuo
    • 1
  • Takashi Mizowaki
    • 1
  • Shinji Uemoto
    • 2
  • Masahiro Hiraoka
    • 1
  1. 1.Department of Radiation Oncology and Image-Applied Therapy, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
  3. 3.Department of Therapeutic RadiologyYamaguchi University Graduate School of MedicineYamaguchiJapan

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