Dose-escalated proton therapy with elective nodal irradiation and concomitant chemotherapy for unresectable, borderline resectable, or medically inoperable pancreatic cancer: a phase II trial.
This study by the Jacksonville group reported treatment outcomes of proton therapy for pancreatic cancer. 15 patients received 40.5 GyRBE in 18 fractions to the gross disease and elective nodal volumes followed by 22.5 GyRBE as a 10-fraction boost to the gross disease for a cumulative dose of 63 GyRBE over 28 fractions. The 1-year OS rate was 47%. Three enrolled patients are currently alive: 2 with no evidence of disease and 1 with stable disease. One patient experienced grade 3 nausea requiring cessation of capecitabine, which ultimately resolved by treatment completion. The primary objective of 1-year OS of 75% for this phase II trial was not reached. This single-institution study was closed to accrual early after the opening of the multicenter PAN009-18 trial by the Proton Collaborative Group (PCG), which follows a similar protocol.