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)

Ding, Xuanfeng; Dionisi, Francesco; Tang, Suqin; Ingram, Mark; Hung, Chi Ren; Prionas, Evangelos; Lichtenwalner, P.; Butterwick, I; Zhai, Huifang; Yin, Lingshu; Lin, Haibo; Kassaee, A; Avery, Stephen

doi:10.1016/j.meddos.2013.11.005

Cited by 50 publications

(39 citation statements)

References 32 publications

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“…Locally advanced pancreatic lesions involve the main pancreatic vessels and retroperitoneum that can lead to incomplete resection, (5) with associated poor survival. Novel radiation therapy techniques with accelerated ion beams have shown positive therapeutic results in local control of locally advanced pancreatic cancer 6 , 7 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

MRI quantification of pancreas motion as a function of patient setup for particle therapy —a preliminary study

Fontana

Riboldi

Gianoli

et al. 2016

J Applied Clin Med Phys

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Particle therapy (PT) has shown positive therapeutic results in local control of locally advanced pancreatic lesions. PT effectiveness is highly influenced by target localization accuracy both in space, since the pancreas is located in proximity to radiosensitive vital organs, and in time as it is subject to substantial breathing‐related motion. The purpose of this preliminary study was to quantify pancreas range of motion under typical PT treatment conditions. Three common immobilization devices (vacuum cushion, thermoplastic mask, and compressor belt) were evaluated on five male patients in prone and supine positions. Retrospective four‐dimensional magnetic resonance imaging data were reconstructed for each condition and the pancreas was manually segmented on each of six breathing phases. A k‐means algorithm was then applied on the manually segmented map in order to obtain clusters representative of the three pancreas segments: head, body, and tail. Centers of mass (COM) for the pancreas and its segments were computed, as well as their displacements with respect to a reference breathing phase (beginning exhalation). The median three‐dimensional COM displacements were in the range of 3 mm. Latero–lateral and superior–inferior directions had a higher range of motion than the anterior–posterior direction. Motion analysis of the pancreas segments showed slightly lower COM displacements for the head cluster compared to the tail cluster, especially in prone position. Statistically significant differences were found within patients among the investigated setups. Hence a patient‐specific approach, rather than a general strategy, is suggested to define the optimal treatment setup in the frame of a millimeter positioning accuracy.PACS number(s): 87.55.‐x, 87.57.nm, 87.61

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Section: Introductionmentioning

confidence: 99%

MRI quantification of pancreas motion as a function of patient setup for particle therapy —a preliminary study

Fontana

Riboldi

Gianoli

et al. 2016

J Applied Clin Med Phys

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“…There are so many articles published about comparision 3D-CRT and IMRT, VMAT techiques for lots of cancer treatment (Swamy et al, 2014;Ding et al, 2014). Some authors have reported dosimetric comparisons of 3D-CRT, IMRT and VMAT for prostate treatment (Romanenko et al, 2003;Xu et al, 2008), direct comparison with our study is difficult.…”

Section: Discussionmentioning

confidence: 72%

“…Secondary malignancies following prostate irradiation include predominantly bladder cancer and, to a lesser extent, colon cancer (Ding et al, 2014;Kendall et al 2007;Nieder et al, 2008;Ruben et al, 2008;Zelefsky 2012;Budaus et al, 2012;Swamy et al, 2014). Those secondary radiation-induced bladder tumors are usually aggressive and sometimes lethal.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Three Dimensional Conformal Radiation Therapy, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy for Low Radiation Exposure of Normal Tissue in Patients with Prostate Cancer

Aydın

Akgün²,

Fayda³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Radiotherapy has an important role in the treatment of prostate cancer. Three-dimensional conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques are all applied for this purpose. However, the risk of secondary radiation-induced bladder cancer is significantly elevated in irradiated patients compared surgery-only or watchful waiting groups. There are also reports of risk of secondary cancer with low doses to normal tissues. This study was designed to compare received volumes of low doses among 3D-CRT, IMRT and VMAT techniques for prostate patients. Ten prostate cancer patients were selected retrospectively for this planning study. Treatment plans were generated using 3D-CRT, IMRT and VMAT techniques. Conformity index (CI), homogenity index (HI), receiving 5 Gy of the volume (V5%), receiving 2 Gy of the volume (V2%), receiving 1 Gy of the volume (V1%) and monitor units (MUs) were compared. This study confirms that VMAT has slightly better CI while thev olume of low doses was higher. VMAT had lower MUs than IMRT. 3D-CRT had the lowest MU, CI and HI. If target coverage and normal tissue sparing are comparable between different treatment techniques, the risk of second malignancy should be a important factor in the selection of treatment.

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“…The field of PBT has made much advancement in a relatively short amount of time. There is currently dosimetric data for each type of cancer discussed that demonstrates superiority of PBT over various other treatment techniques, including 3DCRT, IMRT, and/or volumetric-modulated arc therapy (VMAT) (62)(63)(64)(65)(66)(67)(68)(69)(70). However, determining whether there is a clinical benefit in toxicity profiles or outcomes is a key goal of current and ongoing research, including several prospective clinical trials directly comparing PBT with other RT techniques.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes and toxicities of proton radiotherapy for gastrointestinal neoplasms: a systematic review

Verma

Lin

Simone

et al. 2016

J. Gastrointest. Oncol.

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Background: Proton beam radiotherapy (PBT) is frequently shown to be dosimetrically superior to photon radiotherapy (RT), though supporting data for clinical benefit are severely limited. Because of the potential for toxicity reduction in gastrointestinal (GI) malignancies, we systematically reviewed the literature on clinical outcomes (survival/toxicity) of PBT. Methods: A systematic search of PubMed, EMBASE, abstracts from meetings of the American Society for Radiation Oncology, Particle Therapy Co-Operative Group, and American Society of Clinical Oncology was conducted for publications from 2000-2015. Thirty-eight original investigations were analyzed. Results: Although results of PBT are not directly comparable to historical data, outcomes roughly mirror previous data, generally with reduced toxicities for PBT in some neoplasms. For esophageal cancer, PBT is associated with reduced toxicities, postoperative complications, and hospital stay as compared to photon radiation, while achieving comparable local control (LC) and overall survival (OS). In pancreatic cancer, numerical survival for resected/unresected cases is also similar to existing photon data, whereas grade ≥3 nausea/emesis and post-operative complications are numerically lower than those reported with photon RT.The strongest data in support of PBT for HCC comes from phase II trials demonstrating very low toxicities, and a phase III trial of PBT versus transarterial chemoembolization demonstrating trends towards improved LC and progression-free survival (PFS) with PBT, along with fewer post-treatment hospitalizations. Survival and toxicity data for cholangiocarcinoma, liver metastases, and retroperitoneal sarcoma are also roughly equivalent to historical photon controls. There are two small reports for gastric cancer and three for anorectal cancer; these are not addressed further. Conclusions: Limited quality (and quantity) of data hamper direct comparisons and conclusions. However, the available data, despite the inherent caveats and limitations, suggest that PBT offers the potential to achieve significant reduction in treatment-related toxicities without compromising survival or LC for multiple GI malignancies. Several randomized comparative trials are underway that will provide more definitive answers.

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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)

Cited by 50 publications

References 32 publications

MRI quantification of pancreas motion as a function of patient setup for particle therapy —a preliminary study

MRI quantification of pancreas motion as a function of patient setup for particle therapy —a preliminary study

Comparison of Three Dimensional Conformal Radiation Therapy, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy for Low Radiation Exposure of Normal Tissue in Patients with Prostate Cancer

Clinical outcomes and toxicities of proton radiotherapy for gastrointestinal neoplasms: a systematic review

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