Lymphocyte-Sparing Effect of Stereotactic Body Radiation Therapy in Patients with Unresectable Pancreatic Cancer

Aaron T. Wild, Joseph M. Herman, Avani S. Dholakia, Shalini Moningi, Yao Lu, Lauren M. Rosati, Amy Hacker-Prietz, Ryan K. Assadi, Ali M. Saeed, Timothy M. Pawlik, Elizabeth Jaffee, Daniel Laheru, Phuoc T Tran, Matthew J Weiss, Christopher Wolfgang, Eric Ford, Stuart A Grossman, Xiaobu Ye, Susannah G. Ellsworth

Research output: Contribution to journalArticle

Abstract

Purpose Radiation-induced lymphopenia (RIL) is associated with inferior survival in patients with glioblastoma, lung cancer, and pancreatic cancer. We asked whether stereotactic body radiation therapy (SBRT) decreases severity of RIL compared to conventional chemoradiation therapy (CRT) in locally advanced pancreatic cancer (LAPC). Methods and Materials Serial total lymphocyte counts (TLCs) from patients enrolled in a prospective trial of SBRT for LAPC were compared to TLCs from an existing database of LAPC patients undergoing definitive CRT. SBRT patients received 33 Gy (6.6 Gy × 5 fractions). CRT patients received a median dose of 50.4 Gy (1.8 Gy × 28 fractions) with concurrent 5-fluorouracil (77%) or gemcitabine (23%) therapy. Univariate and multivariate analyses (MVA) were used to identify associations between clinical factors and post-treatment TLC and between TLC and survival. Results Thirty-two patients received SBRT and 101 received CRT. Median planning target volume (PTV) was smaller in SBRT (88.7 cm3) than in CRT (344.6 cm3; P3 vs 13.8% of SBRT patients; P

Original languageEnglish (US)
Pages (from-to)571-579
Number of pages9
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume94
Issue number3
DOIs
StatePublished - 2016

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ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Wild, A. T., Herman, J. M., Dholakia, A. S., Moningi, S., Lu, Y., Rosati, L. M., Hacker-Prietz, A., Assadi, R. K., Saeed, A. M., Pawlik, T. M., Jaffee, E., Laheru, D., Tran, P. T., Weiss, M. J., Wolfgang, C., Ford, E., Grossman, S. A., Ye, X., & Ellsworth, S. G. (2016). Lymphocyte-Sparing Effect of Stereotactic Body Radiation Therapy in Patients with Unresectable Pancreatic Cancer. International Journal of Radiation Oncology, Biology, Physics, 94(3), 571-579. https://doi.org/10.1016/j.ijrobp.2015.11.026