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• W2052052020 abstract "To provide a dosimetric comparison of RapidArc® vs. conventional intensity-modulated radiation therapy for stereotactic body radiation therapy (SBRT) for pancreatic adenocarcinoma. In this study, 5 patients who were previously treated with SBRT at Stanford University using conventional step-and-shoot IMRT (CIMRT) to a dose of 30-33 Gy in 5 fractions were evaluated. For each patient, a new RapidArc® IMRT (RA) plan was generated using 6 MV photons, with two full arcs and alternating collimator angles. The equivalent dose was prescribed to the planning target volume (PTV), which consisted of a 3 mm expansion on the gross tumor volume (GTV). All CIMRT and RA plans were normalized so that 100% of the prescription dose was delivered to 95% of the PTV. Each of the patients had implanted fiducial seeds in the GTV for localization, and all RA plans were generated by a single planner (TA). For the main critical structures, duodenum and stomach, the dose to 3 cc (D3), 9 cc (D9), 16 cc (D16), maximum dose (Dmax), mean dose (Dmean), volume that receives 5 Gy (V5), 10 Gy (V10), 15 Gy (V15), 20 Gy (V20), and 25 Gy (V25) were compared between the plans. When compared to the original CIMRT plans, the RA technique was able to produce treatment plans with similar target conformality. Both RA and CIMRT plans had a mean conformality index of 1.08. For the duodenum, the RA plans had lower mean D3 (14.2 Gy vs. 17.3 Gy, p = 0.01), D9 (11.0 Gy vs. 13.0 Gy, p = 0.045), Dmean (10.0 Gy vs. 11.9 Gy, p = 0.03), V25 (0.1 cc vs. 0.7 cc, p = 0.04), and Dmax (28.6 Gy vs. 31.4 Gy, p = 0.0002) compared to the CIMRT plans. The mean D16 (8.5 Gy vs. 9.0 Gy, p = 0.63), V10 (19.5 cc vs. 13.7 cc, p = 0.06), V15 (3.1 cc vs. 6.4 cc, p = 0.11), and V20 (0.6 cc vs. 2.2 cc, p = 0.09) were not different for RA vs. CIMRT. The mean V5 was higher for the RA vs. the CIMRT plans (35.8 cc vs. 33.0 cc, p = 0.01). For the stomach, the mean Dmax was again lower for the RA plans compared to the CIMRT plans (27.4 Gy vs. 30.5 Gy, p = 0.006), but no difference was seen for Dmean or D9. RA was able to significantly reduce the amounts of duodenum and stomach that received high doses of radiation compared to CIMRT for pancreatic SBRT, while lower and intermediate dose regions were larger or similar. Because of the reduction in radiation dose to the duodenum and stomach, RA treatment should decrease the risk of treatment related complications." @default.
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• W2052052020 date "2010-11-01" @default.
• W2052052020 modified "2023-10-16" @default.
• W2052052020 title "Comparison of RapidArc vs. Conventional Intensity Modulated Radiation Therapy for Stereotactic Body Radiation Therapy for Pancreatic Cancer" @default.
• W2052052020 doi "https://doi.org/10.1016/j.ijrobp.2010.07.1818" @default.
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