scholarly journals Intensity modulated radiation therapy reduces gastrointestinal toxicity in locally advanced pancreas cancer

2016 ◽  
Vol 6 (2) ◽  
pp. 78-85 ◽  
Author(s):  
Shreya Prasad ◽  
Lajhem Cambridge ◽  
Florence Huguet ◽  
Joanne F. Chou ◽  
Zhigang Zhang ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Pancreas Cancer ◽  
Locally Advanced ◽  
Intensity Modulated Radiation Therapy ◽  
Gastrointestinal Toxicity ◽  
Intensity Modulated

scholarly journals Dose-Painted Intensity Modulated Radiation Therapy Improves Local Control for Locally Advanced Pancreas Cancer

ISRN Oncology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Ahmet Tunceroglu ◽  
Joo Han Park ◽  
Sairam Balasubramanian ◽  
Matthew Poppe ◽  
Christopher J. Anker ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Adverse Events ◽  
Induction Chemotherapy ◽  
Local Control ◽  
Pancreas Cancer ◽  
Locally Advanced ◽  
Intensity Modulated Radiation Therapy ◽  
Intensity Modulated ◽  
Concomitant Boost ◽  
3D Crt

Background. To evaluate the outcomes, adverse events, and therapeutic role of Dose-Painted Intensity-Modulated Radiation Therapy (DP-IMRT) for locally advanced pancreas cancer (LAPC). Methods. Patients with LAPC were treated with induction chemotherapy (n=25) and those without metastasis (n=20) received DP-IMRT consisting of 45 Gy to Planning Treatment Volume 1 (PTV1) including regional lymph nodes with a concomitant boost to the PTV2 (gross tumor volume + 0.5 cm) to either 50.4 Gy (n=9) or 54 Gy (n=11) in 25 fractions. DP-IMRT cases were compared to three-dimensional conformal radiation therapy (3D-CRT) plans to assess the potential relationship of radiation dose to adverse events. Kaplan-Meier and Cox regression analyses were used to calculate survival probabilities. The Fisher exact test and t-test were utilized to investigate potential prognostic factors of toxicity and survival. Results. Median overall and progression-free survivals were 11.6 and 5.9 months, respectively. Local control was 90%. Post-RT CA-19-9 levels following RT were predictive of survival (P=0.02). Grade 2 and ≥grade 3 GI toxicity were 60% and 20%, respectively. In comparison to 3D-CRT, DP-IMRT plans demonstrated significantly lower V45 values of small bowel (P=0.0002), stomach (P=0.007), and mean liver doses (P=0.001). Conclusions. Dose-escalated DP-IMRT offers improved local control in patients treated with induction chemotherapy for LAPC. Radiation-related morbidity appears reduced with DP-IMRT compared to 3D-CRT techniques, likely due to reduction in RT doses to organs at risk.

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