To investigate the safety and efficacy of re-irradiation with stereotactic body radiotherapy(SBRT) for treating locally recurrent advanced pancreatic cancer.

From 2014 to 2017, 7 patients with stage Ⅲ pancreatic cancer were treated by re-irradiated with SBRT at Shanghai Changhai Hospital. SBRT was delivered via the G4 type cyberknife robotic stereotactic radiosurgery system in all the patients. The median dose of the first SBRT was 35Gy/5-7 fx, and the median dose of re-irradiation with SBRT was 31 Gy/5-8 fx. 6 patients had undergone sequential chemotherapy either with gemcitabine or S-1 based therapy except one patient who refused the chemotherapy.

There were 5 male and 2 female patients. The median overall survival (OS) of 7 patients was 30 months. Patients were re-irradiated with SBRT after a median interval of 10 months after the first SBRT. Median OS and locally relapse-free survival (LFRS) from re-irradiation were 13 months and 11 months, respectively. Three months after re-irradiation, 3(42.9%) patients had partial remission and 4 patients had stable disease. Pain disappeared in 4 patients at the end of re-irradiation and significant pain was alleviated in 2 patients 1 month after re-irradiation. There were no toxicities of grade 3 or higher grade during two courses of SBRT.

For patient with locally recurrent advanced pancreatic cancer, SBRT re irradiation regimen was associated with acceptable toxicity, which can effectively alleviate the pain, prolong the survival and improve the life quality.

Pancreatic neoplasms; Radiotherapy; Radiotherapy planning, computer-assisted; Stereotactic techniques; Recurrence