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Radiosensitivity index predicts for survival with adjuvant radiation in resectable pancreatic cancer.

Radiosensitivity index predicts for survival with adjuvant radiation in resectable pancreatic cancer.

Authors :
Strom T
Hoffe SE
Fulp W
Frakes J
Coppola D
Springett GM
Malafa MP
Harris CL
Eschrich SA
Torres-Roca JF
Shridhar R
Source :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2015 Oct; Vol. 117 (1), pp. 159-64. Date of Electronic Publication: 2015 Jul 30.
Publication Year :
2015

Abstract

Background and Purpose: Adjuvant radiation therapy for resectable pancreatic cancer remains controversial. Sub-populations of radiosensitive tumors might exist given the genetic heterogeneity of pancreatic cancers. We evaluated whether RSI is predictive of survival in pancreatic cancer treated with radiation.<br />Materials and Methods: We identified 73 genomically-profiled pancreas cancer patients treated with upfront surgery between 2000 and 2011 (48 radiation, 25 no radiation). Briefly, RSI score is derived from the expression of 10 specific genes and a linear regression algorithm modeled on SF2 of 48 cancer cells. The primary endpoint was to assess the association of RSI with overall survival.<br />Results: Median follow-up was 67months for surviving patients. On multivariate analysis, patients with radioresistant tumors had a trend toward worse survival (Hazard ratio [HR] 2.1 [95% CI 1.0-4.3], p=0.054). Among high-risk, irradiated patients (positive margins, positive lymph nodes, or a post-operative CA19-9 >90; n=31), radiosensitive patients had significantly improved survival compared with radioresistant patients (median 31.2 vs. 13.2months; HR 0.42 [0.19, 0.94], p=0.04). Among irradiated patients (n=48), low-risk patients lived longer than both high-risk patients with radiosensitive tumors and radioresistant tumors (HR 2.7 [1.0, 7.2], p=0.04 and HR 6.3 [2.3, 17.0], p<0.001, respectively).<br />Conclusions: Integrating RSI with standard high-risk variables has the potential to refine the classification of high-risk resected pancreatic cancer patients treated with radiation therapy.<br /> (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1879-0887
Volume :
117
Issue :
1
Database :
MEDLINE
Journal :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Publication Type :
Academic Journal
Accession number :
26235848
Full Text :
https://doi.org/10.1016/j.radonc.2015.07.018