Many patients with locally advanced pancreatic cancer develop significant cancer-related pain. PAINPANC was a prospective, phase 2 trial, where 30 patients with pain levels of 5-10 out of 10 were treated with 24 Gy in 3 once weekly fractions for pain relief. The target volume included the gross tumor with a 5 mm CTV margin and a generous 1 cm AP and 2 cm craniocaudal PTV margin. They prescribed 24 Gy to 95% of this target with a maximum dose of 107%. Overall, 73% of patients completed all 3 fractions with the rest either having progression or clinical deterioration. The majority (80%) had at least a 2 point reduction in pain level, and in 70% pain improvement was durable until death or last follow up. Over half (55%) were able to reduce their pain medication requirement after treatment while 21% required the same amount of pain medication, and 17% actually had an increased requirement. | Valverde, Int J Radiat Oncol Biol Phys 2023
