Quality of Life and Acute Radiation Toxicity Following Hypofractionated Stereotactic Body Radiation Therapy with Concurrent Full-Dose Gemcitabine for Unresectable Pancreatic Adenocarcinoma

336 Background: Quality of life (QoL) is of paramount importance when cure is not obtainable. The aim of this study is to report QoL outcomes and acute radiation toxicity in patients with pancreatic cancer treated with stereotactic body radiation therapy (SBRT) and concurrent gemcitabine. Methods: This prospective study reviewed the charts of 10 patients with locally advanced, unresectable pancreatic cancer treated with SBRT and 6 cycles of gemcitabine. The primary tumor and adjacent para-aortic nodes received a total dose of 2500 cGy in 500 cGy fractions on consecutive days between cycles 1 and 2 of gemcitabine. QoL was assessed on the 1st day of each cycle using the EORTC QLQ-C30 and EORTC QLQ-PAN26 questionnaires. Wilcoxon rank sum test was used to determine statistical significance between QoL scores. Toxicity was graded by NCI Common Terminology Criteria for Adverse Events, Version 3.0. Results: The median age was 62.5 years. All patients completed the prescribed SBRT. Median overall survival was 13 months (range 5- 17). QoL scores at baseline compared to immediately after SBRT showed an increase in the following symptoms: fatigue, nausea/vomiting (N/V) and anorexia, which were statistically significant (P < 0.05). These were not statistically different from baseline by cycle 3 except N/V. No symptoms were significantly improved after radiation therapy; however, there was a trend towards improvement in back pain, night pain and abdominal discomfort. Functional scales declined after treatment, but not significantly. Global QoL did not significantly change from baseline. There were no grade 3 or 4 acute toxicities related to SBRT. Conclusions: Hypofractionated SBRT with concurrent gemcitabine is feasible for locally advanced, unresectable pancreatic cancer. There is a temporary increase in selected symptoms due to radiation which resolve within one month. This may be an improvement compared to conventional fractionated radiation due to shorter duration of symptoms related to radiation treatment.