Investigate the Dosimetric and Potential Clinical Benefits Utilizing Stereotactic Body Radiation Therapy With Simultaneous Integrated Boost Technique for Locally Advanced Pancreatic Cancer: A Comparison Between Photon and Proton Beam Therapy

• Published in: Frontiers in oncology 2021-09, Vol.11, p.747532-747532
• Main Authors: Liu, Peilin, Gao, Xian-Shu, Wang, Zishen, Li, Xiaomei, Xi, Cao, Jia, Chenghao, Xie, Mu, Lyu, Feng, Ding, Xuanfeng
• Format: Article
• Language: English
• Subjects: intensity modulated proton therapy (IMPT); normal tissue complication probability (NTCP); Oncology; pancreatic cancer; simultaneous integrated boost (SIB); stereotactic body radiation therapy (SBRT); volumetric modulated arc therapy (VMAT)
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2021.747532

To investigate the potential clinical benefits of using stereotactic body radiation therapy (SBRT) with simultaneous integrated boost (SIB) technique for locally advanced pancreatic cancer (LAPC) among different treatment modalities and planning strategies, including photon and proton. A total of 19 patients were retrospectively selected in this study: 13 cases with the tumor located in the head of the pancreas and 6 cases with the tumor in the body of the pancreas. SBRT-SIB plans were generated using volumetric modulated arc therapy (VMAT), two-field Intensity Modulated Proton Therapy (IMPT), and three-field IMPT. The IMPT used the robust optimization parameters of ± 3.5% range and 5-mm setup uncertainties. Root-mean-square deviation dose (RMSD) volume histograms were used to evaluate the target coverage robustness quantitatively. Dosimetric metrics based on the dose-volume histogram (DVH), homogeneity index (HI), and normal tissue complication probability (NTCP) were analyzed to evaluate the potential clinical benefits among different planning groups. With a similar CTV and SIB coverage, two-field IMPT provided a lower maximum dose for the stomach (median: 18.6GyE, p