In locally advanced pancreatic cancer (LAPC), stereotactic body radiation therapy (SBRT) has been applied as an alternative to concurrent chemoradiotherapy (CCRT); however, direct comparative evidence between these two modalities is scarce. The aim of this study was to compare the clinical outcomes of SBRT with CCRT for LAPC. We retrospectively reviewed the medical records of patients with LAPC who received SBRT (n = 95) or CCRT (n = 66) with a concurrent 5-FU-based regimen between January 2008 and July 2016. The clinical outcomes of freedom from local progression (FFLP), progression-free survival (PFS), overall survival (OS), and toxicities were analyzed before and after propensity score (PS) matching. After a median follow-up duration of 15.5 months (range, 2.3–64.5), the median OS, PFS, and FFLP of the unmatched patients were 17.3 months, 11 months, and 19.6 months, respectively. After PS matching, there were no significant differences between the SBRT and CCRT groups in terms of the 1-year rates of OS (66.7% vs. 80%, p = 0.455), PFS (40.0% vs. 54.2%, p = 0.123), and FFLP (77.2% and 87.1%, p = 0.691). Our results suggest SBRT could be a feasible alternative to CCRT in treating patients with LAPC.

Objectives: This study aimed to evaluate the efficacy and toxicity of stereotactic body radiotherapy (SBRT) for spinal metastases, focusing on pain control, local tumor control, and the incidence of vertebral compression fractures (VCF). Materials and Methods: We retrospectively analyzed 179 patients with 217 spinal metastatic lesions who underwent SBRT between July 2020 and April 2022. The prescribed doses for SBRT were 18 or 20 Gy for one fraction, ≥24 Gy for three fractions, ≥20 Gy for four fractions, and ≥25 Gy for five fractions. Patient-reported treatment response was evaluated 1–3 months after SBRT completion. Local recurrence was defined as failure within the radiotherapy field. Pain response, local progression-free survival (LPFS), and the incidence of painful VCF were assessed. Prognostic factors for LPFS and VCF risk factors were evaluated. Results: The overall pain response rate was 80.8%. LPFS rates were 90.6% at 1 year and 83.0% at 2 years. Lytic/mixed lesions and involvement of multiple segments were significant prognostic factors for reduced LPFS. The cumulative incidence of painful VCF was 8.7% at 1 year and 12.8% at 2 years. A biologically effective dose (BED₃) ≥104 Gy was the only significant risk factor for painful VCF. Conclusions: SBRT demonstrated high efficacy for pain and local tumor control in spinal metastases, with an acceptable VCF risk.

Evidence supporting metastasis-directed local ablative therapy (LAT) in head and neck squamous cell carcinoma (HNSCC) with oligometastatic disease (OMD) is limited. We retrospectively reviewed 93 patients with HNSCC who developed OMD and received LAT to all metastatic sites between 2006 and 2025. Clinical variables, sarcopenia, nutritional status, and inflammatory indices were evaluated as potential predictors of overall survival (OS), progression-free survival (PFS), polymetastasis-free survival (PMFS), and polymetastatic conversion (PC). An exploratory prognostic nomogram for PMFS was developed to inform treatment decision-making. After a median follow-up of 28.2 months, the 3-year OS and PMFS rates were 67.2% and 51.7%, respectively. Local failure occurred in 9 patients, while disease progression was predominantly distant. An HPV-positive oropharyngeal primary tumor was associated with improved OS and PMFS, whereas non-lung metastatic sites were adverse prognostic factors for PFS, and having two or more metastases was adverse for PC. Lower serum albumin levels correlated with worse OS and PFS, and an increasing systemic immune-inflammation index (SII) showed borderline significance for OS and PMFS. A PMFS nomogram based on four clinical parameters achieved an optimism-corrected concordance index of 0.66. Long-term survival and high local control were observed in this selected cohort of HNSCC patients with OMD treated with LAT. Tumor type, metastatic site, tumor burden, and host nutritional and inflammatory indices were associated with survival and progression to PC.