Palliative Two-Dimensional Radiotherapy of Pancreatic Carcinoma: A Feasibility Study

Morganti, Alessio Giuseppe; Marinelli, Alfonso; Buwenge, M.; Macchia, G.; Deodato, F.; Massaccesi, Mariangela; Kigula-Mugambe, Joseph; Tigeneh, Wondemagegnhu; Dawotola, D.; Caravatta, L.; Sallustio, Giuseppina; Piermattei, Angelo; Valentini, Vincenzo; Cilla, S.

doi:10.1177/030089161309900408

Cited by 4 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a previous study, we observed that with 2D-SRT, it is possible to meet the current standard dose-volume constraints ( 7 ) only by using lower total doses (30–36 Gy) ( 11 ). In a subsequent study, we defined the optimal fields size for involved-field irradiation of CaP with 2D-SRT technique ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of 2D‑conformal radiotherapy for pancreatic carcinoma

Buwenge

Cilla²,

Cammelli

et al. 2018

Oncol Lett

Self Cite

View full text Add to dashboard Cite

The purpose of the present study was to propose an optimized 2D technique (2D-conformal) for radiotherapy (RT) of pancreatic cancer (CaP). This technique is based on double simulation which resolves the problems of radiographic image distortion. Five patients with locally advanced CaP were identified and enrolled. Treatment planning was simulated in 3 different ways: Two dimensional-standard (2D-SRT), 2D-conformal (2D-CRT), and three dimensional-conformal (3D-CRT) techniques for 10 MV LINAC. Simulation for a cobalt machine was also performed using only the 2D techniques. 2D-SRT technique was planned with fields definition based on anatomical landmarks (bone and duodenum). 3D-CRT was planned with standard virtual simulation technique, and 3D dose evaluation and optimization. 2D-CRT technique was based on manual information transfer from a diagnostic CT-scan to simulation radiograms. To eliminate the X-ray image distortion, a double simulation was employed and the profile of the GTV was delineated on radiographs bearing the simulator isocenter into the target center. Concerning target irradiation of either LINAC (10 MV) or cobalt source, the PTV constraints (ICRU 62) were met in all patients (Dmin >95%, Dmax <107%) with all techniques (2D-SRT, 3D-CRT, 2D-CRT). For organs at risk irradiation, in terms of Dmax to both duodenum and spinal cord, similar results were recorded with all techniques using the LINAC (10 MV). Liver and kidneys Dmean gradually improved from 2D-SRT to 2D-CRT and 3D-CRT. The 2D-CRT compared to 2D-SRT technique, halved the average dose to the liver and reduced to about 1/3 the average dose to the kidneys. With the cobalt source, using the 2D-CRT produced a reduction of Dmean to the kidneys (median from 30.7 to 16.9%) and liver (median from 33.4 to 22.3%) compared to 2D-SRT. This analysis showed better planning results in RT treatment of CaP while using a 2D-CRT compared to 2D-SRT technique and therefore presents an example for optimized 2D RT use.

show abstract

Section: Discussionmentioning

confidence: 99%

Feasibility of 2D‑conformal radiotherapy for pancreatic carcinoma

Buwenge

Cilla²,

Cammelli

et al. 2018

Oncol Lett

Self Cite

View full text Add to dashboard Cite

show abstract

“…In conclusion, we aimed at providing convenient 2D PCa target delineation tools. In the last years, our team worked on the optimization of 2D-RT in palliative treatments (33)(34)(35). Worth noting is that 2D-RT is still in use in several centers in the world.…”

Section: Treatment Machine ------------------------------------------mentioning

confidence: 99%

Definition of fields margins for the optimized 2D radiotherapy of prostate carcinoma

Buwenge

Perrone²,

Siepe

et al. 2019

mol clin onc

Self Cite

View full text Add to dashboard Cite

Prostate cancer (PCa) is one of the most common malignancies in men both in western and developing countries. Radiotherapy (RT) is an important therapeutic option. New technologies (including 3D, intensity modulated RT, image-guided RT and, volumetric modulated arc therapy) have been introduced in the last few decades with progressive improvement of clinical outcomes. However, in many developing countries, the only treatment option is the traditional two-dimensional (2D) technique based on standard simulation. The guidelines for 2D field definition are still based on expert's opinions. The aim of the present study was to propose new practical guidelines for 2D fields definition based on 3D simulation in PCa. A total of 20 patients were enrolled. Computed tomography-simulation and pelvic magnetic resonance images were merged to define the prostate volumes. Clinical Target Volume (CTV) was defined using the European Organisation for Research and Treatment of Cancer guidelines in consideration of the four risk categories: Low, intermediate, and high risk with or without seminal vesicles involvement, respectively. Planning Target Volume (PTV) was defined by adding 10 mm to the CTV. For each category, two treatment plans were calculated using a cobalt source or 10 MV photons. Progressive optimization was achieved by evaluating 3D dose distribution. Finally, the optimal distances between field margins and radiological landmarks (bones and rectum with contrast medium) were defined. The results were reported in tabular form. Both field margins (PTV D 98% >95%) needed to adequately irradiate all patients and to achieve a similar result in 95% of the enrolled patients are reported. Using a group of patients with PCa and based on a 3D planning analysis, we propose new practical guidelines for PCa 2D-RT based on current criteria for risk category and CTV, and PTV definition.

show abstract