Analysis of Dosimetric Parameters Associated With Acute Gastrointestinal Toxicity and Upper Gastrointestinal Bleeding in Locally Advanced Pancreatic Cancer Patients Treated With Gemcitabine-Based Concurrent Chemoradiotherapy

Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

“…The V 10Gy , V 20Gy , V 30Gy , V 40Gy , D 2cc and the D mean of the stomach and duodenum have been indicated to be strong predictors for gastrointestinal toxicity (22)(23)(24)(25). For each plan, these parameters were determined, as were the V 20Gy and D mean of the kidney closest to the PTV (ipsilateral kidney) and the D max of the spinal cord.…”

Treatment of abdominal tumors using radiotherapy

“…47,53 The main complication reported when there is an excess dose is decrease in renal function when the kidney's dose is greater than its tolerance (B). 54 Assessments of the dose received by irradiated organ volume show the tolerance thresholds below which there is no toxicity (B) [55][56][57][58][59][60][61] (D). 62 Several prospective studies associate dosimetric parameters and toxicity of the organs at risk, showing lower toxicity with conformal therapy compared to conventional radiotherapy (B) 20,63,64 (C) 65 (D).…”

Feasibility of intensity-modulated radiotherapy combined with gemcitabine and S-1 for patients with pancreatic cancer

“…A total of 22% of these patients suffered grade 3 or worse GI toxicities, and there was a substantial difference in GI toxicities amongst patients with a PTV ≥260 ml and those with a PTV <260 ml. Nakamura et al (15) reported that GI toxicity was associated with the stomach V 50 in gemcitabine-based chemoradiotherapy. In their study, a gemcitabine dose of 250 mg/m 2 was administrated weekly together with three-dimensional conformal radiotherapy, and GTV was defined as the primary tumor plus the metastatic lymph nodes.…”

“…Nakamura et al (15) reported that only 5% of patients had peripancreatic lymph node recurrence even though the PTV was limited to the primary tumor with a 1 cm margin that did not include the draining lymph node. The study concluded that the use of an irradiated volume encompassing only the GTV was not the cause of marginal failure, and resulted in fewer toxicities.…”