A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT)
| Autor: | Alireza Kassaee, Evangelos Prionas, Xuanfeng Ding, Lingshu Yin, Shikui Tang, Ian Butterwick, Chun-Yu Hung, Huifang Zhai, Stephen Avery, Phil Lichtenwalner, Francesco Dionisi, M Ingram, Haibo Lin |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Radiation Dosage Pancreatic tumor Pancreatic cancer medicine Proton Therapy Humans Radiology Nuclear Medicine and imaging Radiation treatment planning Proton therapy Retrospective Studies Chemotherapy Radiological and Ultrasound Technology business.industry Radiotherapy Planning Computer-Assisted Intensity-modulated radiation therapy medicine.disease Radiation therapy Pancreatic Neoplasms medicine.anatomical_structure Oncology Radiology Radiotherapy Intensity-Modulated Pancreas Nuclear medicine business |
| Zdroj: | Medical dosimetry : official journal of the American Association of Medical Dosimetrists. 39(2) |
| ISSN: | 1873-4022 |
| Popis: | With traditional photon therapy to treat large postoperative pancreatic target volume, it often leads to poor tolerance of the therapy delivered and may contribute to interrupted treatment course. This study was performed to evaluate the potential advantage of using passive-scattering (PS) and modulated-scanning (MS) proton therapy (PT) to reduce normal tissue exposure in postoperative pancreatic cancer treatment. A total of 11 patients with postoperative pancreatic cancer who had been previously treated with PS PT in University of Pennsylvania Roberts Proton Therapy Center from 2010 to 2013 were identified. The clinical target volume (CTV) includes the pancreatic tumor bed as well as the adjacent high-risk nodal areas. Internal (iCTV) was generated from 4-dimensional (4D) computed tomography (CT), taking into account target motion from breathing cycle. Three-field and 4-field 3D conformal radiation therapy (3DCRT), 5-field intensity-modulated radiation therapy, 2-arc volumetric-modulated radiation therapy, and 2-field PS and MS PT were created on the patients’ average CT. All the plans delivered 50.4 Gy to the planning target volume (PTV). Overall, 98% of PTV was covered by 95% of the prescription dose and 99% of iCTV received 98% prescription dose. The results show that all the proton plans offer significant lower doses to the left kidney (mean and V 18 Gy ), stomach (mean and V 20 Gy ), and cord (maximum dose) compared with all the photon plans, except 3-field 3DCRT in cord maximum dose. In addition, MS PT also provides lower doses to the right kidney (mean and V 18 Gy ), liver (mean dose), total bowel (V 20 Gy and mean dose), and small bowel (V 15 Gy absolute volume ratio) compared with all the photon plans and PS PT. The dosimetric advantage of PT points to the possibility of treating tumor bed and comprehensive nodal areas while providing a more tolerable treatment course that could be used for dose escalation and combining with radiosensitizing chemotherapy. |
| Databáze: | OpenAIRE |
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