Dosimetric benefit of adaptive re-planning in pancreatic cancer stereotactic body radiotherapy

Yongbao Li, Jeremy D P Hoisak, Nan Li, Carrie Jiang, Zhen Tian, Quentin Gautier, Masoud Zarepisheh, Zhaoxia Wu, Yaqiang Liu, Xun Jia, Jona Hattangadi-Gluth, Loren K. Mell, Steve Jiang, James D. Murphy

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Stereotactic body radiotherapy (SBRT) shows promise in unresectable pancreatic cancer, though this treatment modality has high rates of normal tissue toxicity. This study explores the dosimetric utility of daily adaptive re-planning with pancreas SBRT. We used a previously developed supercomputing online re-planning environment (SCORE) to re-plan 10 patients with pancreas SBRT. Tumor and normal tissue contours were deformed from treatment planning computed tomographies (CTs) and transferred to daily cone-beam CT (CBCT) scans before re-optimizing each daily treatment plan. We compared the intended radiation dose, the actual radiation dose, and the optimized radiation dose for the pancreas tumor planning target volume (PTV) and the duodenum. Treatment re-optimization improved coverage of the PTV and reduced dose to the duodenum. Within the PTV, the actual hot spot (volume receiving 110% of the prescription dose) decreased from 4.5% to 0.5% after daily adaptive re-planning. Within the duodenum, the volume receiving the prescription dose decreased from 0.9% to 0.3% after re-planning. It is noteworthy that variation in the amount of air within a patient[U+05F3]s stomach substantially changed dose to the PTV. Adaptive re-planning with pancreas SBRT has the ability to improve dose to the tumor and decrease dose to the nearby duodenum, thereby reducing the risk of toxicity.

Original languageEnglish (US)
Pages (from-to)318-324
Number of pages7
JournalMedical Dosimetry
Volume40
Issue number4
DOIs
StatePublished - 2015

Keywords

  • CBCT
  • Interfraction anatomic changes
  • Online adaptive re-planning
  • Pancreatic cancer
  • SBRT

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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  • Cite this

    Li, Y., Hoisak, J. D. P., Li, N., Jiang, C., Tian, Z., Gautier, Q., Zarepisheh, M., Wu, Z., Liu, Y., Jia, X., Hattangadi-Gluth, J., Mell, L. K., Jiang, S., & Murphy, J. D. (2015). Dosimetric benefit of adaptive re-planning in pancreatic cancer stereotactic body radiotherapy. Medical Dosimetry, 40(4), 318-324. https://doi.org/10.1016/j.meddos.2015.04.002