Beam angle selection for intensity-modulated radiotherapy (IMRT) treatment of unresectable pancreatic cancer: are noncoplanar beam angles necessary?

• Published in: Clinical & translational oncology 2013-09, Vol.15 (9), p.720-724
• Main Authors: Chang, D. S., Bartlett, G. K., Das, I. J., Cardenes, H. R.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - radiotherapy; Algorithms; Humans; Kidney - radiation effects; Medicine; Medicine & Public Health; Oncology; Organs at Risk; Pancreatic Neoplasms - radiotherapy; Radiometry - methods; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted - methods; Radiotherapy, Intensity-Modulated - instrumentation; Radiotherapy, Intensity-Modulated - methods; Research Article; Risk Factors
• ISSN: 1699-048X; 1699-3055
• DOI: 10.1007/s12094-012-0998-5

Background and purpose External beam radiation therapy with concurrent chemotherapy (CRT) is widely used for the treatment of unresectable pancreatic cancer. Noncoplanar (NCP) 3D conformal radiotherapy (3DCRT) and coplanar (CP) IMRT have been reported to lower the radiation dose to organs at risk (OARs). The purpose of this article is to examine the utility of noncoplanar beam angles in IMRT for the management of pancreatic cancer. Materials and methods Sixteen patients who were treated with CRT for unresectable adenocarcinoma of the pancreatic head or neck were re-planned using CP and NCP beams in 3DCRT and IMRT with the Varian Eclipse treatment planning system. Results Compared to CP IMRT, NCP IMRT had similar target coverage with slightly increased maximum point dose, 5,799 versus 5,775 cGy ( p  = 0.008). NCP IMRT resulted in lower mean kidney dose, 787 versus 1,210 cGy ( p