Dosimetric performance of cone beam CT-guided adaptive carbon-ion radiotherapy with daily replanning for pancreatic cancer

Purpose - We investigated whether an ultra-hypofractionated carbon-ion radiotherapy (CIRT) protocol for pancreatic cancer (PC) could produce satisfactory dosimetric results with or without cone-beam CT-guided adaptive replanning and explored the potential dosimetric advantages of the adapted protoco...

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Hauptverfasser: Klassen, Lukas Fabrizio (VerfasserIn) , Hirashima, Hideaki (VerfasserIn) , Iramina, Hiraku (VerfasserIn) , Iwai, Takahiro (VerfasserIn) , Yoshimura, Michio (VerfasserIn) , Tanaka, Hiroki (VerfasserIn) , Mizowaki, Takashi (VerfasserIn) , Nakamura, Mitsuhiro (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 10 May 2025
In: Physica medica
Year: 2025, Jahrgang: 134, Pages: 1-7
ISSN:1724-191X
DOI:10.1016/j.ejmp.2025.104991
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejmp.2025.104991
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1120179725001012
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Verfasserangaben:Lukas Fabrizio Klassen, Hideaki Hirashima, Hiraku Iramina, Takahiro Iwai, Michio Yoshimura, Hiroki Tanaka, Takashi Mizowaki, Mitsuhiro Nakamura

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245 1 0 |a Dosimetric performance of cone beam CT-guided adaptive carbon-ion radiotherapy with daily replanning for pancreatic cancer  |c Lukas Fabrizio Klassen, Hideaki Hirashima, Hiraku Iramina, Takahiro Iwai, Michio Yoshimura, Hiroki Tanaka, Takashi Mizowaki, Mitsuhiro Nakamura 
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520 |a Purpose - We investigated whether an ultra-hypofractionated carbon-ion radiotherapy (CIRT) protocol for pancreatic cancer (PC) could produce satisfactory dosimetric results with or without cone-beam CT-guided adaptive replanning and explored the potential dosimetric advantages of the adapted protocol. - Methods - Eleven PC patients who underwent CBCT-guided online adaptive photon radiotherapy were selected. Data were imported into a CIRT treatment planning software to develop new plans for an ultra-hypofractionated CIRT protocol. Prescriptions and constraints were recalculated for a five-fraction schedule using a linear quadratic model for organs-at-risk (OARs) and targets, respectively. The biologically effective dose-equivalent prescribed dose was set at 43.2 Gy (relative biological effectiveness [RBE]). Each day, a synthetic CT (SCT) was generated from the planning CT (PCT) with the daily CBCT. A reference plan based on the PCT was compared to an adapted plan based on the SCT. Deformable image registration was used to allow summation of the daily doses. - Results - The adapted plans met the clinical goals, whereas the reference plans exceeded the constraints in 27 % (stomach), 53 % (duodenum), and 31 % (small bowel) of the fractions. The adapted plans notably decreased V35.5 Gy[RBE] for all gastrointestinal OARs, while significantly enhancing the gross tumor volume (GTV) D95% and planning target volume (PTV) D90%. The accumulated doses showed significant improvements in the duodenum V35.5 Gy[RBE], GTV D95%, and PTV D90%. - Conclusion - CBCT-guided adaptive CIRT for PC demonstrated favorable dosimetric results, notably enhancing the sparing of OARs and ensuring superior target coverage compared with non-adaptive CIRT protocols. 
650 4 |a Adaptive radiotherapy 
650 4 |a Carbon-ion radiotherapy 
650 4 |a Cone-beam CT 
650 4 |a Hypofractionation 
650 4 |a Pancreatic cancer 
700 1 |a Hirashima, Hideaki  |e VerfasserIn  |4 aut 
700 1 |a Iramina, Hiraku  |e VerfasserIn  |4 aut 
700 1 |a Iwai, Takahiro  |e VerfasserIn  |4 aut 
700 1 |a Yoshimura, Michio  |e VerfasserIn  |4 aut 
700 1 |a Tanaka, Hiroki  |e VerfasserIn  |4 aut 
700 1 |a Mizowaki, Takashi  |e VerfasserIn  |4 aut 
700 1 |a Nakamura, Mitsuhiro  |e VerfasserIn  |4 aut 
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