Pain response after palliative-intent radiotherapy for pancreatic cancer: a systematic review.

BACKGROUND

To date, no review has specifically focused on palliative-intent radiotherapy (RT) for pancreatic cancer (PC)-related pain. This study aimed to evaluate the pain response after palliative-intent RT for PC-related pain.

METHODS

A comprehensive literature search was conducted using PubMed, Ichushi-Web, and the Cochrane Library for studies published between 1971 and 2024. Studies in which palliative-intent RT was administered for PC-related pain were included. Extracted Data were independently assessed by three reviewers.

RESULTS

Of the 629 studies identified through the database search, 11 met the inclusion criteria. The most frequently used palliative-intent RT schedules were 30 Gy in 10 fractions for conventional RT and 25 Gy in a single fraction for stereotactic body radiotherapy (SBRT). In addition, 8 Gy once weekly (24 Gy in 3 fractions) RT has also been reported. Because the methods used for pain assessment varied across the included studies, a meta-analysis was considered inappropriate. Pain associated with PC improved following palliative-intent conventional RT (pain response rate, 69-94%), palliative-intent SBRT (pain response rate, 53-90%), and 8 Gy once weekly RT (pain response rate, 80%). A few grade ≥ 3 gastrointestinal adverse events were reported (< 10%).

CONCLUSION

Palliative-intent RT appears to be a promising approach for alleviating PC-related pain. However, the current evidence is heterogeneous in terms of target selection and dose-fractionations. Further studies, including randomized controlled trials, may help identify optimal treatment strategies.