Survey Study on the Patterns of Practice for Pancreatic Cancer Radiation Therapy in Korea

Abstract

Introduction This study aims to analyse the practice patterns of radiotherapy (RT) for pancreatic cancer (PC) in Korea.Methods A questionnaire comprising 17 questions on RT for PC was sent to board-certified radiation oncologists participating in the Division for Pancreaticobiliary Cancer of the Korean Radiation Oncology Group.Results Twenty-three hospitals participated in the survey. In 2022, 11 hospitals reported adjuvant RT cases after resection (66 patients), 4 hospitals reported neoadjuvant RT cases before surgery (80 patients), and 16 hospitals reported definitive RT cases for locally advanced PC (197 patients). Adjuvant RT dose and fractionation varied across institutions, either conventional (45-54 Gy in 25-30 fractions) or hypofractionated (37.5-45 Gy in 15 fractions) regimen. Definitive RT indications included progressive disease or an increase in tumour markers during systemic therapy (12 responses), incomplete systemic therapy due to treatment-related adverse event (10 responses), ineligibility for multiagent chemotherapy due to patient performance including old age or comorbidities (9 responses), planned RT after completion of chemotherapy according to the institutional protocol (3 responses), and ineligible for conversion surgery despite the completion of chemotherapy (3 responses). The application of RT techniques and dose-fractionation schedules also varied depending on the available equipped machine, tumour location, and relationship with neighbouring organs at risk.Conclusions Current analysis showed significant heterogeneity in the practice patterns of RT for PC in Korea, particularly in dose fractionation schedules and RT indications. These findings highlight the need for further research and standardisation of RT practices to optimise treatment outcomes.