ESTRO 2024 - Abstract Book

S2244

Clinical - Upper GI

ESTRO 2024

Keywords: Pancreatic cancer, hypo-fractionated, adrotherapy

2328

Digital Poster

Analysis of biomarkers and radiomics in pancreatic cancer patients receiving neoadjuvant treatment

Divya Khosla 1 , Gaganpreet Singh 1 , Rakesh Kapoor 1 , Vandana Thakur 1 , Rajesh Gupta 2 , Divyesh Kumar 1 , Mahendra Kumar 3 , Arun S Oinam 1 , Surinder s Rana 4 , Shikha Goyal 1 , Renu Madan 1 1 Postgraduate Institute of Medical Education and Research (PGIMER), Department of Radiotherapy and Oncology, Regional Cancer Centre, Chandigarh, India. 2 Postgraduate Institute of Medical Education and Research (PGIMER), Department of Surgical Gastroenterology, Chandigarh, India. 3 Postgraduate Institute of Medical Education and Research (PGIMER), Department of Immunopathology, Chandigarh, India. 4 Postgraduate Institute of Medical Education and Research (PGIMER), Department of Gastroenterology, Chandigarh, India

Purpose/Objective:

The prognosis of pancreatic cancer remains dismal despite advances in cancer treatment. Borderline and locally advanced pancreatic cancer are treated with neoadjuvant therapy which can be either in the form of neoadjuvant chemotherapy (NACT) alone, neoadjuvant chemotherapy followed by chemoradiation (CRT) or neoadjuvant chemoradiation (NACRT). Stereotactic body radiotherapy (SBRT) has the advantages of higher conformality and offering shorter treatment duration. The current study's objective is to compare the biomarkers, quality of life and radiomics in patients of borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) treated with neoadjuvant chemotherapy followed by CRT or SBRT.

Material/Methods:

This is a prospective study carried from January 2021 to December 2022 (CTRI/2021/10/037538). Twenty patients of BRPC and LAPC were enrolled in this study (10 in CRT arm and 10 in SBRT arm). NACT was given prior to chemoradiation and SBRT to all patients. Blood based biomarkers such as CD4:CD8 counts, Neutrophil lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) were analyzed for all the patients at baseline, pre-radiotherapy (RT), one-month post RT and three months post RT. CD4 and CD8 subsets were analyzed using flow cytometry. Quality of life (QOL) was assessed using QOL 30 and QOL Pan 26 questionnaire at the baseline, pre-RT, one month post RT and then 3 months post completion of RT. Four weeks after RT, re-staging was done and the patients were assessed for surgery. Difference with the baseline scores at different intervals between the two groups were compared using Chi-square test. Radiomic features were extracted from planning CT images using pyRadiomics module.

Results: