In Silico Study of Simultaneous Integrated Boost Carbon-Ion Radiotherapy for Locally Advanced Pancreatic Cancer.

IF 1.6 4区医学 Q4 ONCOLOGY Anticancer research Pub Date : 2024-09-01 DOI:10.21873/anticanres.17208

Taku Nakaji, Makoto Shinoto, Shigeru Yamada, Taku Inaniwa

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Abstract

Background/aim: Carbon-ion radiotherapy (CiRT) has been used for the treatment of locally advanced pancreatic cancer (LAPC) with uniform dose plan. The aim of the present study is to investigate the effectiveness of a simultaneous integrated boost (SIB) technique with scanned CiRT against LAPC.

Materials and methods: Data of 21 patients with LAPC were used to compare two treatment planning approaches: a conventional uniform dose approach and a SIB approach. A relative biological effectiveness (RBE)-weighted dose (D_RBE) of 55.2 Gy (RBE) in 12 fractions was prescribed to the planning target volume (PTV) in the conventional approach. In the SIB approach, D_RBE of 67.2 Gy (RBE) and 43.2 Gy (RBE) in 12 fractions were prescribed to a high-risk PTV (HR-PTV) and low-risk PTV (LR-PTV), respectively. The D_RBE and dose-averaged linear energy transfer (LET_d) of targets and gastrointestinal tracts as organs at risk (OARs) were evaluated.

Results: The HR-PTV D_90% and LR-PTV D_90% were 64.4±0.6 and 42.5±0.1 Gy (RBE) in SIB approach compared to the PTV D_90% of 54.1±0.4 Gy (RBE) in the conventional approach. All SIB plans achieved the D_2cc lower than 46 Gy (RBE) and V₃₀ lower than 4 cm³ within OARs. The SIB approach increased the minimum LET_d within the GTV to 44 keV/μm or higher for 20 out of 21 patients as compared to 16 out of 21 patients in the conventional approach.

Conclusion: The SIB approach effectively increased the RBE-weighted dose and LET_d within the HR-PTV and GTV by accumulating the high-LET stopping carbon-ions into the HR-PTV in addition to the decreased RBE-weighted dose to OARs.

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针对局部晚期胰腺癌的同步综合碳-离子放射治疗的硅学研究

背景/目的：碳离子放疗（CiRT）已被用于治疗局部晚期胰腺癌（LAPC），并采用统一的剂量计划。本研究的目的是探讨扫描碳离子放疗与同步综合增强（SIB）技术对局部晚期胰腺癌的疗效：21例LAPC患者的数据用于比较两种治疗计划方法：传统的均匀剂量方法和SIB方法。在传统方法中，规划靶体积（PTV）的相对生物效应（RBE）加权剂量（DRBE）为 55.2 Gy（RBE），共分 12 次。在 SIB 方法中，对高风险 PTV（HR-PTV）和低风险 PTV（LR-PTV）分别规定了 12 次分割的 67.2 Gy（RBE）和 43.2 Gy（RBE）的 DRBE。评估了靶点和胃肠道作为危险器官（OAR）的DRBE和剂量平均线性能量转移（LETd）：结果：SIB方法的HR-PTV D90%和LR-PTV D90%分别为64.4±0.6和42.5±0.1 Gy (RBE)，而传统方法的PTV D90% 为54.1±0.4 Gy (RBE)。所有SIB计划的D2cc均低于46 Gy（RBE），OAR内的V30均低于4 cm3。SIB方法将21名患者中的20名患者GTV内的最小LETd提高到44 keV/μm或更高，而传统方法则将21名患者中的16名患者GTV内的最小LETd提高到44 keV/μm或更高：结论：SIB方法通过将高LET停止碳离子聚集到HR-PTV，有效地增加了RBE加权剂量以及HR-PTV和GTV内的LETd，同时降低了OARs的RBE加权剂量。

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.