Evaluating dosimetric constraints for carbon ion radiotherapy in the treatment of locally advanced pancreatic cancer

Lien Chun Lin, Guo Liang Jiang, Nitin Ohri, Zheng Wang, Jiade J. Lu, Madhur Garg, Chandan Guha, Xiaodong Wu

Research output: Contribution to journalArticle

Abstract

Objective: To identify a safe carbon ion radiotherapy (CIRT) regimen for patients with locally advanced pancreatic cancer (LAPC). Methods: We generated treatment plans for 13 consecutive, unselected patients who were treated for LAPC with CIRT at our center using three dose and fractionation schedules: 4.6 GyRBE × 12, 4.0 GyRBE × 14, and 3.0 GyRBE × 17. We tested the ability to meet published dose constraints for the duodenum, stomach, and small bowel as a function of dose schedule and distance between the tumor and organs at risk. Results: Using 4.6 GyRBE × 12 and 4.0 GyRBE × 14, critical (high-dose) constraints could only reliably be achieved when target volumes were not immediately adjacent to organs at risk. Critical constraints could be met in all cases using 3.0 GyRBE × 17. Low-dose constraints could not uniformly be achieved using any dose schedule. Conclusion: While selected patients with LAPC may be treated safely with a CIRT regimen of 4.6 GyRBE × 12, our dosimetric analyses indicate that a more conservative schedule of 3.0 GyRBE × 17 may be required to safely treat a broader population of LAPC patients, including those with large tumors and tumors that approach gastrointestinal organs at risk. The result of this work was used to guide an ongoing clinical trial.

Original languageEnglish (US)
Article number101
JournalRadiation Oncology
Volume15
Issue number1
DOIs
StatePublished - May 7 2020

Keywords

  • Carbon ion
  • Pancreatic cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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