Hiroki Kawaguchi1, Yusuke Demizu2, Naritoshi Mukumoto1, Takeaki Ishihara1, Daisuke Miyawaki1, Shohei Komatsu3, Hiroaki Akasaka1,4, Makoto Shinoto5, Yoshiyuki Shioyama6, Katsumasa Nakamura7, Takumi Fukumoto3, Ryohei Sasaki8. 1. Division of Radiation Oncology, Kobe University Hospital, Kobe, Japan. 2. Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Japan. 3. Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. 4. Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan. 5. QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan. 6. Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan. 7. Department of Radiation Oncology, Hamamatsu University School of Medicine, Hamamatsu, Japan. 8. Division of Radiation Oncology, Kobe University Hospital, Kobe, Japan; rsasaki@med.kobe-u.ac.jp.
Abstract
BACKGROUND/AIM: We aimed to investigate the dosimetric effects of a spacer placed between the pancreas and surrounding gastrointestinal structures in intensity-modulated radiation therapy (IMRT) planning to provide more effective radiation therapy for locally advanced pancreatic cancer (LAPC). PATIENTS AND METHODS: Treatment planning was performed for six patients with LAPC based on computed tomography images without spacers and with 5-mm or 10-mm spacers virtually inserted under the supervision of a hepatobiliary pancreatic surgeon. The prescription dose was 63 Gy in 28 fractions. RESULTS: With the exception of one case of pancreatic head cancer, planning target volume receiving ≥95% of the prescribed dose (PTV V95) was achieved by 90% or more by inserting a spacer, and by 95% or more in all 3 cases of pancreatic body and tail cancer by inserting a 10-mm spacer. CONCLUSION: IMRT with appropriate spacer placement may help provide high-dose treatment for LAPC and improve associated patient outcomes. Copyright
BACKGROUND/AIM: We aimed to investigate the dosimetric effects of a spacer placed between the pancreas and surrounding gastrointestinal structures in intensity-modulated radiation therapy (IMRT) planning to provide more effective radiation therapy for locally advanced pancreatic cancer (LAPC). PATIENTS AND METHODS: Treatment planning was performed for six patients with LAPC based on computed tomography images without spacers and with 5-mm or 10-mm spacers virtually inserted under the supervision of a hepatobiliary pancreatic surgeon. The prescription dose was 63 Gy in 28 fractions. RESULTS: With the exception of one case of pancreatic head cancer, planning target volume receiving ≥95% of the prescribed dose (PTV V95) was achieved by 90% or more by inserting a spacer, and by 95% or more in all 3 cases of pancreatic body and tail cancer by inserting a 10-mm spacer. CONCLUSION: IMRT with appropriate spacer placement may help provide high-dose treatment for LAPC and improve associated patient outcomes. Copyright