Survival benefits and disparities in radiation therapy for elderly patients with pancreatic ductal adenocarcinoma

Table 4 Summary of studies on radiation therapy for elderly patients with pancreatic ductal adenocarcinoma

Ref.	No. of patients	Median age (range), years	Clinical stage	Median dose (range), Gy	Median follow-up (months)	Technique	Treatment modality	OS1	Toxicities (%)
Davila et al[14], 2009	553	> 65	I-III	NR	NR	NR	Surg: 51%	NR	NR
							Surg + CRT: 31%
							Surg + CT: 9.0%
							Surg + RT: 9.0%
Miyamoto et al[17], 2010	42	78 (75–90)	I-III	48.1 (38.9–57.3)	11.7 (2.9–41.7)	3D-CRT/IMRT	CRT: 57.1%	mOS: 8.6 mo2	Acute (G ≥ 3): 49.0
							Surg + CRT: 40.5%	mOS: 20.6 mo3	Late (G ≥ 2): NR
							CRT + Surg: 2.4%
Horowitz et al[16], 2011	49	79 (75–90)	I-II	50.0	19 (2.6–57.4)	NR	Surg + CRT: 29.5%	mOS: 22.6 mo	NR
							Surg: 70.5%	5 yr-OS: 49.7%
Kim et al[19], 2013	26	86 (80–91)	I-IV	24 (22–36)	11.6 (3.5–24.6)	SBRT	RT ± CT: 100%	LC: 11.5 mo	Acute (G ≥ 3): 0.0
								MFS: 8.4 mo	Late (G ≥ 2): 0.0
								mOS: 7.6 mo
								2 yr-OS: 6.6%
Herman et al[20], 2015	33	> 65	NR	33	13.9 (3.9–45.2)	SBRT	CT+ RT + CT ± Surg: 89.8%	mOS: 11.0 mo	NR
							RT + CT ± Surg: 10.2%	2 yr-OS: 20%
Hayman et al[15], 2015	53	77 (> 70)	NR	50 (43.2–63.0)	36	NR	Surg: 30.4%	mOS: 21.1 mo	NR
							Surg + CT: 22.3%
							Surg + CRT: 47.3%
Yechieli et al[21], 2017	20	83.2 (77-90)	I-II	35 (30–36)	5.3 (2.3–26.2)	SBRT	RT: 100%	mOS: 6.4 mo	Acute (G ≥ 3): 0.0
								2 yr-OS: 7.7%	Late (G ≥ 2): 15.0
Zhu et al[22], 2017	417	73 (65–90)	II-IV	NR (30–46.8)	11 (4–28)	SBRT	CT + RT: 11.2%	LC: 10.0 mo	Acute (G ≥ 3): 0.5
							Surg + RT: 7.7%	PFS: 8.0 mo	Late (G ≥ 3): 0.0
							RT: 81.1%	MFS: 9.5 mo
								mOS: 10.0 mo
								1 yr-OS: 35.5%
Frakes et al[18], 2017	555	75 (70–88)	I-III	NR	NR	NR	Surg + RT: 100%	mOS: 19.0 mo	NR
Sutera et al[23], 2018	145	79 (70.1-90.3)	I-III	36 Gy/3f or 24 Gy/f	12.3 (6.0–23.3)	SBRT	Surg + RT: 30.3%	mOS: 40.0 mo
							CT + RT: 53.8%	1 yr-LC: 72%	Acute (G ≥ 3): 0.7
								2 yr-LC: 63%	Acute (G ≥ 2): 4.1
							RT: 15.9%	1 yr-MFS: 62%	Late (G ≥ 3): 1
								2 yr-MFS: 47%	Late (G ≥ 2): 2

¹Reported results refers only to patients treated with radiotherapy.

²Definitive chemoradiation.

³Adjuvant chemoradiation.

CRT: Chemoradiotherapy; CT: Chemotherapy; 3D-CRT: Three-dimensional conformal radiotherapy; IMRT: Intensity modulated radiotherapy; LC: Local control; MFS: Metastasis free survival; NR: Not reported; OS: Overall survival; RT: Radiation therapy; SBRT: Stereotactic body radiotherapy; Surg: Surgery; G: Grade.