Dosimetric Comparison between Dynamic Wave Arc and Co-Planar Volumetric Modulated Radiotherapy for Locally Advanced Pancreatic Cancer

سال انتشار: 1401
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 131

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شناسه ملی سند علمی:

JR_IJMP-19-1_001

تاریخ نمایه سازی: 22 اسفند 1400

چکیده مقاله:

Introduction: Dose reduction to the duodenum is important to decrease gastrointestinal toxicities in patients with locally advanced pancreatic cancer (LAPC) treated with definitive chemoradiotherapy. We aimed to compare dynamic wave arc (DWA), a volumetric-modulated beam delivery technique with simultaneous gantry/ring rotations passing the waved trajectories, with coplanar VMAT (co-VMAT) with respect to dose distributions in LAPC cases. Material and Methods: DWA and co-VMAT plans were created for ۱۳ patients with LAPC. The prescribed dose was ۴۵.۶ or ۴۸ Gy in ۱۵ fractions. The dose volume indices (DVIs) for target volumes and organs at risk were compared between the corresponding plans. Gamma passing rate, monitor unit (MU), and beam-on time were also compared.  Results: DWA significantly reduced the duodenal V۳۹Gy, V۴۲Gy, and V۴۵Gy by ۱.۱, ۰.۸, and ۰.۲ cm۳, and increased the liver mean dose and D۲cm۳ of the spinal cord planning volume by ۱.۰ and ۱.۵ Gy, respectively. Meanwhile, there was no significant difference in the target volumes except for D۲% of PTV (۱۱۱.۵% in DWA vs. ۱۱۰.۵% in co-VMAT). Further, the gamma passing rate was similar in both plans. MU and beam-on time increased in DWA by ۳۱ MUs and ۱۵ seconds, respectively.  Conclusion: DWA generated significantly lower duodenal doses in LAPC cases, albeit with slight increasing liver and spinal cord doses and increasing MU and the beam delivery time. Further evaluation is needed to know how the dose differences would affect the clinical outcomes in chemoradiotherapy for LAPC.

کلیدواژه ها:

Radiotherapy Planning Computer ، Assisted Pancreas Cancer Volumetric Modulated Arc Therapy

نویسندگان

Alshaymaa Abdelghaffar

Department of Clinical Oncology, Sohag University Hospital, Sohag University, Sohag, Egypt; and Guest Research Associate, Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Noriko Kishi

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Ryo Ashida

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan; and Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan.

Yukinori Matsuo

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Hideaki Hirashima

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Nobutaka Mukumoto

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Michio Yoshimura

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Mitsuhiro Nakamura

Department of Information Technology and Medical Engineering, Human Health Sciences, Graduate School of Medicine, Kyoto University; and Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University,

Ahmed El Sayed Mohamed

Department of Clinical Oncology, Sohag University Hospital, Sohag University, Sohag, Egypt.

Elsayed Mostafa

Department of Clinical Oncology, Sohag University Hospital, Sohag University, Sohag, Egypt.

Mohamed Soliman Gaber

Department of Clinical Oncology, Sohag University Hospital, Sohag University, Sohag, Egypt.

Takashi Mizowaki

Department of Radiation Oncology and Image-Applied Therapy Kyoto University Graduate School of Medicine、Kyoto, Japan.

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