Comparison of carbon-ion passive and scanning irradiation for pancreatic cancer

Shiomi, Miho; Mori, Shinichiro; Shinoto, Makoto; Nakayama, Yuko; Kamada, Tadashi; Yamada, Shigeru

doi:10.1016/j.radonc.2016.04.026

Cited by 31 publications

(28 citation statements)

References 19 publications

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“…Shiomi et at. [27] evaluated, how the use of specific beam directions might increase the plan robustness for the case of passive and active delivery systems. Moreover, a complementary approach is the use of abdominal compression to reduce the motion amplitude and additional beam rescanning to mitigate the interplay effect [28].…”

Section: Discussionmentioning

confidence: 99%

Planning strategies for inter-fractional robustness in pancreatic patients treated with scanned carbon therapy

et al. 2017

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BackgroundManaging inter-fractional anatomy changes is a challenging task in radiotherapy of pancreatic tumors, especially in scanned carbon-ion delivery. This treatment planning study aims to focus on clinically feasible solutions, such as the beam angle selection and margin design to increase the robustness against inter-fractional uncertainties.MethodsThis study included 10 patients with weekly 3D-CT imaging and physician-approved Clinical Target Volume (CTV). The study was directed to keep the CTV-coverage using six beam angle configurations in combination with different Internal Target Volume (ITV) concepts. These were: geometric-margin (symmetric 3 and 5 mm margin); range-equivalent margins with an isotropic HU replacement; and to evaluate the need of asymmetric margins the water-equivalent range path (WEPL) was determined per patient from the set of CTs.Plan optimization and forward dose calculation in each week-CT were performed with the research treatment planning system TRiP98 and the plan quality evaluated in terms of CTV coverage (V95CTV) and homogeneity dose (HCTV = D5-D95).ResultsThe beam geometry had a substantial impact on the target irradiation over the treatment course, with the single posterior or two beams showing the best average coverage of the CTV. The use of geometric margins for the more robust beam geometries showed acceptable results, with a V95CTV of (99.2 ± 1.2)% for the 5 mm-margin. For the non-robust configurations, due to substantial changes in the radiological depth, the use of this margin results in a V95CTV that might be below 80%, only showing improvement when the range changes are included.ConclusionsSelection of adequate beam configurations and treatment margins in ion-beam therapy of pancreatic tumors is of great importance. For a single posterior beam or two beam configurations, application of geometrical margins compensate for dose degradation induced by inter-fractional anatomy changes for the majority of the analyzed treatment fractions.Electronic supplementary materialThe online version of this article (doi:10.1186/s13014-017-0832-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Planning strategies for inter-fractional robustness in pancreatic patients treated with scanned carbon therapy

et al. 2017

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“…CIRT for passive irradiation was validated in this study. A similar effect would be observed in layer-stacking irradiation or scanning irradiation with CIRT, and these techniques might reduce the bowel dose more than passive irradiation because they have better conformity (14,15). Additionally, a similar effect would be observed in proton therapy because the proton beams also exhibit a Bragg peak and sharp dose distribution (16)(17)(18).…”

Section: Discussionmentioning

confidence: 71%

Development of a Vaginal Immobilization Device: A Treatment-planning Study of Carbon-ion Radiotherapy and Intensity-modulated Radiation Therapy for Uterine Cervical Cancer

et al. 2019

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Aim: We developed a vaginal immobilization device for external radiotherapy in gynaecological malignancies and evaluated its bowel dose-reduction effect during carbon-ion radiotherapy (CIRT) and intensitymodulated radiation therapy (IMRT) in patients with cervical cancer. Patients and Methods: Computed tomographic images obtained with and without the device in seven patients with cervical cancer were assessed. Treatment plans for CIRT and IMRT were generated, and dose-volume parameters (V 20 , V 25 , V 35 , and D 2cc) of the rectum, sigmoidal colon, and bladder were evaluated. Results: The mean±standard deviation of the rectal volume in CIRT for V 35 with and without the device were 2.1±2.1 and 13.6±4.4 ml, respectively, and those in IMRT were 2.0±2.2 and 13.7±3.8 ml, respectively; these values were significantly lower in CIRT and IMRT using this device. Conclusion: Using our novel vaginal immobilization device, high rectal doses were largely reduced in CIRT and IMRT. High-precision external-beam therapy for uterine cervical cancer ideally requires sparing the dose to organs at risk such as the rectum, bladder, sigmoidal colon, and pelvic bones as much as possible (1-3). For instance, it is possible to reduce 1915 This article is freely accessible online.

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“…The volume of jawbone receiving more than 50 Gy (RBE) in 16 fractions was found to be a risk factor of ORN . The technological advancements made in recent years in scanning‐beam and gantry‐based treatment delivery reduce the volume of the jawbone that is exposed to high‐dose irradiation, which may decrease the risk of ORN …”

Section: Discussionmentioning

confidence: 99%

“…10 The technological advancements made in recent years in scanning-beam and gantry-based treatment delivery reduce the volume of the jawbone that is exposed to high-dose irradiation, which may decrease the risk of ORN. 34,35 C-ion RT is a promising treatment option for inoperable oral non-SCC. Since April 2018, the public health insurance system in Japan has covered C-ion RT for head and neck malignancies, with the exception of oral, laryngeal, and pharyngeal SCC.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of carbon‐ion radiotherapy for oral non‐squamous cell carcinomas

et al. 2019

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Background This study evaluated carbon‐ion radiotherapy (C‐ion RT) for oral non‐squamous cell carcinomas (non‐SCC). Methods We retrospectively obtained data from 74 patients who underwent C‐ion RT for oral malignancies between April 1997 and March 2016. The C‐ion RT was administered in 16 fractions at a total dose of 57.6 or 64.0 Gy (relative biological effectiveness). Results Forty‐three patients had salivary gland carcinomas, 29 patients had mucosal melanoma, and 2 patients had other types of pathologies. The tumors were classified as T1‐T3 (24 cases), T4a (21 cases), or T4b (29 cases). The median follow‐up was 49 months. The 5‐year rates were 78.8% for local control, 36.2% for progression‐free survival, and 58.3% for overall survival. Although 10 patients developed grade 3 osteoradionecrosis after C‐ion RT, all patients maintained their mastication and deglutition functions after sequestrectomy and prosthesis placement. Conclusion C‐ion RT was effective for oral non‐SCC and had acceptable toxicities.

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Comparison of carbon-ion passive and scanning irradiation for pancreatic cancer

Cited by 31 publications

References 19 publications

Planning strategies for inter-fractional robustness in pancreatic patients treated with scanned carbon therapy

Planning strategies for inter-fractional robustness in pancreatic patients treated with scanned carbon therapy

Development of a Vaginal Immobilization Device: A Treatment-planning Study of Carbon-ion Radiotherapy and Intensity-modulated Radiation Therapy for Uterine Cervical Cancer

Feasibility of carbon‐ion radiotherapy for oral non‐squamous cell carcinomas

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