Carbon-ion radiotherapy (CIRT) as treatment of pancreatic cancer at HIT

• Verfasst von: Baltazar, Filipa [VerfasserIn]
• Verfasst von: Tessonnier, Thomas [VerfasserIn]
• Verfasst von: Haberer, Thomas [VerfasserIn]
• Verfasst von: Debus, Jürgen [VerfasserIn]
• Verfasst von: Herfarth, Klaus [VerfasserIn]
• Verfasst von: Tawk, Bouchra [VerfasserIn]
• Verfasst von: Knoll, Maximilian [VerfasserIn]
• Verfasst von: Abdollahi, Amir [VerfasserIn]
• Verfasst von: Liermann, Jakob [VerfasserIn]
• Verfasst von: Mairani, Andrea [VerfasserIn]
• Titel: Carbon-ion radiotherapy (CIRT) as treatment of pancreatic cancer at HIT
• Titelzusatz: initial radiation plan analysis of the prospective phase II PACK-study
• Verf.angabe: Filipa Baltazar, Thomas Tessonnier, Thomas Haberer, Juergen Debus, Klaus Herfarth, Bouchra Tawk, Maximilian Knoll, Amir Abdollahi, Jakob Liermann, Andrea Mairani
• E-Jahr: 2023
• Jahr: November 2023
• Umfang: 7 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 25. August 2023, Artikelversion: 12. September 2023 ; Gesehen am 05.12.2023
• Titel Quelle: Enthalten in: Radiotherapy and oncology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1983
• Jahr Quelle: 2023
• Band/Heft Quelle: 188(2023) vom: Nov., Artikel-ID 109872, Seite 1-7
• ISSN Quelle: 1879-0887
• DOI: doi:10.1016/j.radonc.2023.109872
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Carbon ion radiotherapy
• Sach-SW: Gastrointestinal toxicity
• Sach-SW: Pancreatic cancer
• Sach-SW: Treatment dose constraints
• K10plus-PPN: 1871941377

Abstract

Purpose - To analyze the dose objectives and constraints applied at the prospective phase II PACK-study at Heidelberg ion therapy center (HIT) for different radiobiological models. - Methods - Treatment plans of 14 patients from the PACK-study were analyzed and recomputed in terms of physical, biological dose and dose-averaged linear energy transfer (LETd). Both LEM-I (local effect model 1) and the adapted NIRS-MKM (microdosimetric kinetic model), were used for relative biological effectiveness (RBE)-weighted dose calculations (DBio|HIT and DBio|NIRS). A new constraint to the gastrointestinal (GI) tract was derived from the National Institute of Radiological Science (NIRS) clinical experience and considered for plan reoptimization (DBio|NIRS-const_48Gy and DBio|NIRS-const_50.4Gy). The Lyman-Kutcher-Burman (LKB) model of Normal Tissue Complication Probability (NTCP) for GI toxicity endpoints was computed. Furthermore, the computed LETd distribution was evaluated and correlated with Local Control (LC). - Results - Only two patients showed a LETd98% in the GTV greater than 44 keV/μm. A HIT-dose constraint to the GI of D2cm3=48.6GyRBEHIT was derived from the NIRS experience, in alternative to the standard at HIT Dmax = 45.6 GyRBEHIT. In comparison with the original DBio|HIT, DBio|NIRS-const_48GyandDBio|NIRS-const_50.4Gy resulted in an increase in the ITV’s D98% of 8.7% and 11.3%. The NTCP calculation resulted in a probability for gastrointestinal bleeding of 4.5%, 12.3% and 13.0%, for DBio|NIRS, DBio|NIRS-const_48Gy and DBio|NIRS-const_50.4Gy, respectively. - Conclusion - The results indicate that the current standards applied at HIT for CIRT closely align with the Japanese experience. However, to enhance tumor coverage, a more relaxed constraint on the GI tract may be considered. As the PACK-trial progresses, further analyses of various clinical endpoints are anticipated.