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01.03.2018 | Original Article | Ausgabe 7/2018 Open Access

Strahlentherapie und Onkologie 7/2018

Nonmetastatic pancreatic cancer

Improved survival with chemoradiotherapy > 40 Gy after systemic treatment

Strahlentherapie und Onkologie > Ausgabe 7/2018
M.D. Sebastian Bachmayer, M.D. Gerd Fastner, M.D. Andrea Vaszi, M.D. Wolfgang Iglseder, Ph.D. Peter Kopp, M.D. Josef Holzinger, M.D. Adam Dinnewitzer, M.D. Gabriel Rinnerthaler, M.D. Simon Peter Gampenrieder, M.D. Klaus Emmanuel, M.D. Richard Greil, M.D. Felix Sedlmayer, M.D., M.Sc. Franz Zehentmayr
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00066-018-1281-7) contains supplementary material, which is available to authorized users.



The role of radiotherapy (RT) for nonmetastatic pancreatic cancer is still a matter of debate since randomized control trials have shown inconsistent results. The current retrospective single-institution study includes both resected and unresected patients with nonmetastasized pancreatic cancer. The aim is to analyze overall survival (OS) after irradiation combined with induction chemotherapy.

Patients and methods

Of the 73 patients with nonmetastatic pancreatic cancer eligible for the present analysis, 42 (58%) patients had adjuvant chemoradiotherapy (CRT), while 31 (42%) received CRT as primary treatment. In all, 65 (89%) had chemotherapy at any time before, during, or after RT, and 39 (53%) received concomitant CRT. The median total dose was 50 Gy (range 12–77 Gy), while 61 (84%) patients received >40 Gy.


With a median follow-up of 22 months (range 1.2–179.8 months), 14 (19%) are still alive and 59 (81%) of the patients have died, whereby 51 (70%) were cancer-related deaths. Median OS and the 2‑year survival rate were 22.9 months (1.2–179.8 months) and 44%, respectively. In addition, 61 (84%) patients treated with >40 Gy had a survival advantage (median OS 23.7 vs. 17.3 months, p = 0.026), as had patients with 4 months minimum of systemic treatment (median OS 27.5 vs. 14.3 months, p = 0.0004).


CRT with total doses >40 Gy after induction chemotherapy leads to improved OS in patients with nonmetastatic pancreatic cancer.

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Supplementary figure 1. Overall survival in resected patients compared by duration of systemic treatment before RT
Supplementary figure 2. Overall survival in unresected patients compared by duration of systemic treatment before RT
Supplementary table 1. Overview of prospective, retrospective and population-based studies
Supplementary table 2. Prospective studies for LAPC
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