Radiation therapy clearly improves survival in certain pancreatic cancer patients, according to City of Hope researchers. The findings refute arguments that the treatment has little or no benefit.
Despite advances in therapy, pancreatic cancer remains a dire diagnosis. Less than 30 percent of patients whose cancer is caught early, when it is most treatable, survive at least five years after diagnosis. Most patients die in less than two years.
In a recent study, clinical researchers led by Joseph Kim, M.D., determined that external beam radiation therapy (EBRT), together with surgery, could extend the lives of pancreatic cancer patients whose disease has not spread to lymph nodes. EBRT encompasses therapies using high-energy X-rays or protons, and can include TomoTherapy, City of Hope’s targeted radiation therapy system.
“There have been concerns and doubts about the benefit of EBRT with surgery in pancreatic cancer patients,” said Kim. “Our findings lead us to continue to recommend the therapy for patients with early stage disease.” Unfortunately, despite advanced imaging scans, many of these cancers are still discovered at late stages, when the cancer is not confined to the pancreas, Kim explained.
To assess radiation’s effects on outcomes in these patients, the research team examined the National Cancer Institute’s Surveillance, Epidemiology and End Results registry. They selected the records of more than 1,900 patients spanning 15 years who underwent surgery to remove their pancreatic cancer. About one-third of those patients received EBRT, as well.
Researchers analyzed the data and found a 30 percent decrease in the risk of death for those patients receiving EBRT — and the typical patient who received radiation lived about five months longer compared to those without radiation.
“We still don’t see a cure by any means,” said City of Hope surgical oncology fellow Avo Artinyan, M.D., the study’s lead author, “but the improvement is clear, and adding five months to someone’s life is no small advantage.”
Artinyan, who performed the records analysis for the study, is currently collaborating on several similar studies on gastrointestinal cancers with researchers in the departments of Population Sciences, Radiation Oncology and Surgery at City of Hope.
By examining outcomes from a large database of patient records, the investigators seek to uncover trends and advantages in treatment methods and decisions. The work represents a powerful approach to examining the relative benefits of different therapies.
Kim is enthusiastic about the conclusions the work may offer. “We’re excited about the power of outcomes research,” he said, “and [Artinyan] is brilliant with statistical analysis. We’re lucky to have his expertise on our team.”
Additional City of Hope researchers contributing to the study include Minia Hellen, M.D., Pablo Mojica-Manosa, M.D., and Joshua D. I. Ellenhorn, M.D., of the Department of Surgery, and Yi-Jen Chen, M.D., and Richard Pezner, M.D., of the Department of Radiation Oncology.
The study appeared in the Jan. 1 issue of Cancer.