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Volume 42 Issue 5
May  2026
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Article Navigation >  Journal of Clinical Hepatology  > 2026  >  42(5): 1125-1132

Efficacy and safety of intensity-modulated radiotherapy versus stereotactic body radiotherapy in treatment of locally advanced pancreatic cancer： A meta-analysis

DOI: 10.12449/JCH260518
  • 1.

    The Third Hospital of Shanxi Medical University，Shanxi Bethune Hospital，Shanxi Academy of Medical Sciences，Department of Oncology of Tongji Shanxi Hospital，Taiyuan 030032，China

  • 2.

    Department of Electrocardiogram，Shanxi Fenyang Hospital，Fenyang，Shanxi 032200，China

  • 3.

    School of Dentistry，Tongji University，Shanghai 200070，China

  • 4.

    Department of Radiation Oncology，Shanxi Fenyang Hospital，Fenyang，Shanxi 032200，China

Research funding:

Natural Science Foundation of Shanxi Province (202303021221220)

More Information
  • Corresponding author: GUO Yarong， gyr5258@126.com （ORCID： 0000-0002-3589-5882）
  • Received Date: 2025-11-12
  • Accepted Date: 2026-01-14
  • Published Date: 2026-05-25
    Abstract
  •   Objective  To systematically analyze the differences in therapeutic efficacy between intensity-modulated radiotherapy （IMRT） and stereotactic body radiotherapy （SBRT） for locally advanced pancreatic cancer （LAPC）， and to provide a basis for treatment decision-making.  Methods  PubMed， Embase， the Cochrane Library， CNKI， Wanfang Data， and VIP databases were searched for prospective or retrospective cohort studies on IMRT versus SBRT for the treatment of LAPC published up to July 31， 2025. The Newcastle-Ottawa Scale was used to assess the quality of studies， and Review Manager 5.4 was used to perform the Meta-analysis.  Results  A total of 23 studies involving 2 505 patients were included. In terms of local control rate， an analysis of 13 studies with 847 patients showed that the SBRT group had a significantly higher 1-year local control rate than the IMRT group （84.5% vs 66.7%， relative risk ［RR］=1.27， 95% confidence interval ［CI］： 1.03 — 1.56， I2=28%， P=0.026）. In terms of acute toxicity， an analysis of 15 studies showed that the SBRT group had a significantly lower incidence rate of grade≥3 acute toxicity than the IMRT group （3.5% vs 11.0%， RR=0.32， 95%CI： 0.19 — 0.53， I2=18%， P<0.001）. There was no significant difference in overall survival between the SBRT group and the IMRT group （16.8 months vs 16.3 months）. The subgroup analysis of local control rate showed that in the 9 high-quality studies， the SBRT group had a significantly higher local control rate than the IMRT group （RR=1.25， P<0.001）， and a similar result was observed in the 4 moderate-quality studies （RR=1.31， P=0.021）； the stratified analysis based on technique platforms showed that the MR-guided technique group showed the largest effect size （RR=1.40， I2=10%）. The sensitivity analysis showed that the RR value ranged from 1.21 to 1.28， with stable results. The Egger regression analysis showed no significant publication bias （P>0.05）.  Conclusion  SBRT is superior to IMRT in terms of local control rate and acute toxicity and is a preferred treatment option for LAPC， with the MR-guided techniques showing the best performance.

     

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