Benefits of MRI-Directed Ablative Radiotherapy in Pancreatic Cancer

Michael D. Chuong, MD, a radiation oncologist and medical director of Proton Therapy at Miami Cancer Institute, Baptist Health South Florida, discusses the benefits of MRI-guided radiation therapy in pancreatic cancer.

According to Chuong, MRI-guided radiation therapy is an ablative therapy typically administered over the course of 5 days. It is an option for patients who cannot undergo surgery, at least initially, and still have visible tumor in the pancreas itself. The method has proven more effective compared to lower doses of radiation, or even higher-dose regimens performed on different machines. According to Chuong, the machines seem to not only have an impact on tumor control, but also on long-term patient survival. 

A recent analysis found that patients who received MRI-guided ablative radiation therapy had a median survival of nearly 2 years after some chemotherapy, significantly longer than the historical average of a little over 1 year with standard dose radiotherapy. Additionally, these results were achieved with little significant adverse events. A number of patients reported no adverse events at all. According to Chuong, more studies are needed to confirm findings. 

0:08 | MRI-guided radiation therapy, which is typically delivered in 5 days here, although to an ablative dose, ablative means extremely high and having a surgical type of potential, is something that really could benefit any patient who has no option for surgery at least initially, and who has visible tumor in the pancreas itself. And this is something that we've seen have tremendous impact in terms of what seems to be improving long term local control, as opposed to lower doses of radiation, and even those that can be delivered in 5 days on a different machine. We're seeing potentially dramatic improvement in longevity of the ability to keep tumors from essentially regrowing or coming back in the treated area within the pancreas using ablative MRI guided radiation therapy. And what's exciting is that this seems to potentially not only have an impact on local tumor control, but also potentially a long-term patient survival.

1:18 | So, in our recent analysis, we demonstrated that patients who received ablative MRI guided radiation therapy here, after typically some amount of chemotherapy, had a median survival of nearly 2 years, which is significantly higher than the historical expected outcomes from standard dose radiation, which is typically about 1 year, maybe a little bit more than 1 year. And what's also exciting is that we achieved these results with most patients having no significant adverse effects or side effects. And in fact, a number of our patients really had no reported side effects at all, which is obviously tremendous. This is definitely an exciting time for pancreatic cancer patients as novel treatments such as ablative MRI-guided radiation is emerging. we clearly need additional studies to better understand what the long-term outcomes and results are from this type of treatment. But our experience here at Miami Cancer Institute is one of a growing number of studies that are emerging, essentially demonstrating very similar results leading to in leading to enthusiasm that in fact, this is a viable and promising approach moving forward for patients where surgery is not an option.