Martin Fuss1, Adrian Wong, Clifton D Fuller, Bill J Salter, Cristina Fuss, Charles R Thomas. 1. Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, Texas, the Cancer Therapy & Research Center, San Antonio, and the Department of Radiation Medicine, Oregon Health & Science University, Portland, OR.
Abstract
PURPOSE: To present the techniques and preliminary outcomes of ultrasound-based image-guided intensity-modulated radiotherapy (IG-IMRT) for pancreatic cancer. MATERIALS AND METHODS: Retrospective analysis of 41 patients treated between November 2000 and March 2005 with IG-IMRT to mean total doses of 55 Gy (range, 45-64 Gy). We analyzed the clinical feasibility of IG-IMRT, dosimetric parameters, and outcomes, including acute gastrointestinal toxicity (RTOG grading). Survival was assessed for adenocarcinoma (n = 35) and other histologies. RESULTS: Mean daily image-guidance corrective shifts were 4.8 +/- 4.3 mm, 7.5 +/- 7.2 mm, and 4.6 +/- 5.9 mm along the x-, y-, and z-axes, respectively (mean 3D correction vector, 11.7 +/- 8.4 mm). Acute upper gastrointestinal toxicity was grade 0-1 in 22 patients (53.7%), grade 2 in 16 patients (39%), and grade 3 in 3 patients (7.3%). Lower gastrointestinal toxicity was grade 0-1 in 32 patients (78%), grade 2 in 7 patients (17.1%), and grade 4 in 2 patients (4.9%). Treatment was stopped early in 4 patients following administration of 30 to 54 Gy. Median survival for adenocarcinoma histology was 10.3 months (18.6 months in patients alive at analysis; n = 8) with actuarial 1- and 2-year survivals of 38% and 25%, respectively. CONCLUSION: Daily image-guidance during delivery of IMRT for pancreatic carcinoma is clinically feasible. The data presented support the conclusion that safety margin reduction and moderate dose escalation afforded by implementation of these new radiotherapy technologies yields preliminary outcomes at least comparable with published survival data.
PURPOSE: To present the techniques and preliminary outcomes of ultrasound-based image-guided intensity-modulated radiotherapy (IG-IMRT) for pancreatic cancer. MATERIALS AND METHODS: Retrospective analysis of 41 patients treated between November 2000 and March 2005 with IG-IMRT to mean total doses of 55 Gy (range, 45-64 Gy). We analyzed the clinical feasibility of IG-IMRT, dosimetric parameters, and outcomes, including acute gastrointestinal toxicity (RTOG grading). Survival was assessed for adenocarcinoma (n = 35) and other histologies. RESULTS: Mean daily image-guidance corrective shifts were 4.8 +/- 4.3 mm, 7.5 +/- 7.2 mm, and 4.6 +/- 5.9 mm along the x-, y-, and z-axes, respectively (mean 3D correction vector, 11.7 +/- 8.4 mm). Acute upper gastrointestinal toxicity was grade 0-1 in 22 patients (53.7%), grade 2 in 16 patients (39%), and grade 3 in 3 patients (7.3%). Lower gastrointestinal toxicity was grade 0-1 in 32 patients (78%), grade 2 in 7 patients (17.1%), and grade 4 in 2 patients (4.9%). Treatment was stopped early in 4 patients following administration of 30 to 54 Gy. Median survival for adenocarcinoma histology was 10.3 months (18.6 months in patients alive at analysis; n = 8) with actuarial 1- and 2-year survivals of 38% and 25%, respectively. CONCLUSION: Daily image-guidance during delivery of IMRT for pancreatic carcinoma is clinically feasible. The data presented support the conclusion that safety margin reduction and moderate dose escalation afforded by implementation of these new radiotherapy technologies yields preliminary outcomes at least comparable with published survival data.
Authors: Anurag Chandra; Lei Dong; Eugene Huang; Deborah A Kuban; Laura O'Neill; Isaac Rosen; Alan Pollack Journal: Int J Radiat Oncol Biol Phys Date: 2003-06-01 Impact factor: 7.038
Authors: Edgar Ben-Josef; Anthony F Shields; Ulka Vaishampayan; Vainutis Vaitkevicius; Basil F El-Rayes; Patrick McDermott; Jay Burmeister; Todd Bossenberger; Philip A Philip Journal: Int J Radiat Oncol Biol Phys Date: 2004-06-01 Impact factor: 7.038
Authors: Michael T Milano; Steven J Chmura; Michael C Garofalo; Carla Rash; John C Roeske; Phillip P Connell; Oh-Hoon Kwon; Ashesh B Jani; Ruth Heimann Journal: Int J Radiat Oncol Biol Phys Date: 2004-06-01 Impact factor: 7.038
Authors: Albert C Koong; Quynh T Le; Anthony Ho; Bryan Fong; George Fisher; Cheryl Cho; Jim Ford; Joseph Poen; Iris C Gibbs; Vivek K Mehta; Stephen Kee; Ward Trueblood; George Yang; J Augusto Bastidas Journal: Int J Radiat Oncol Biol Phys Date: 2004-03-15 Impact factor: 7.038
Authors: C H Crane; J A Antolak; I I Rosen; K M Forster; D B Evans; N A Janjan; C Charnsangavej; P W Pisters; R Lenzi; M A Papagikos; R A Wolff Journal: Int J Gastrointest Cancer Date: 2001
Authors: Kwun-Ye Chu; Rosie Cooke; Frank Van den Heuvel; Somnath Mukherjee; Maria A Hawkins Journal: Tech Innov Patient Support Radiat Oncol Date: 2019-12-16