Journal of Radiotherapy

Review Article

Stereotactic Hypofractionated Irradiation for Metastatic, Inoperable, and Recurrent Malignancies: A Modern Necessity, rather than a Luxury

Table 9

Trials using SABR for pancreaticobiliary cancers.
TrialRemarksOutcome
Chang et al. [83] 77 patients with unresectable pancreatic cancer treated with SABR (25 Gy × 1 Fc).Effective for LC. Should be used with rigorous quality assurance to reduce complications. Distant metastases account for the vast majority of mortality.
Rwigema et al. [84] 24 patients treated with SABR adjuvantly after surgical resection. Freedom from local progression was 66% at one year and median OS was 26.7 months. No incidence of grade 3 or 4 toxicity. Shorter treatment course allowed timely initiation of systemic chemotherapy.
Schellenberg et al. [85] Phase-2 trial evaluated LC and OS in patients treated with sequential gemcitabine and SABR (25 Gy × 1 Fc). Freedom from local progression was 94% at 1 year. 1-year survival was 50% (mortalities being mainly from distant metastases).
Barney et al. [86]12 unresectable primary and recurrent cholangiocarcinoma lesions treated with SABR (median dose 55 Gy).Freedom from progression within treated volumes was 100%. OS remained unchanged due to progression elsewhere.
Polistina et al. [87]10 patients with unresectable hilar-cholangiocarcinoma treated with SABR (10 Gy × 3 Fc) and gemcitabine.2-year and 4-year survival were 80% and 30%, respectively.
Fc: fraction; OS: overall survival; LC: local control.