Feasibility of 2D‑conformal radiotherapy for pancreatic carcinoma

Buwenge,Milly; Cilla,Savino; Cammelli,Silvia; Macchia,Gabriella; Arcelli,Alessandra; Farina,Eleonora; Frakulli,Rezarta; Panni,Valeria; Wondemagegnhu,Tigeneh; Uddin,A.  F. M. Kamal; Sumon,Mostafa  A.; Deodato,Francesco; Morganti,Alessio  G.

doi:10.3892/ol.2018.9389

November-2018 Volume 16 Issue 5

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November-2018 Volume 16 Issue 5

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Article Open Access

Feasibility of 2D‑conformal radiotherapy for pancreatic carcinoma

Authors:
- Milly Buwenge
- Savino Cilla
- Silvia Cammelli
- Gabriella Macchia
- Alessandra Arcelli
- Eleonora Farina
- Rezarta Frakulli
- Valeria Panni
- Tigeneh Wondemagegnhu
- A. F. M. Kamal Uddin
- Mostafa A. Sumon
- Francesco Deodato
- Alessio G. Morganti
View Affiliations / Copyright

Affiliations: Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine‑DIMES, University of Bologna, S. Orsola‑Malpighi Hospital, 40138 Bologna, Italy, Medical Physic Unit, Fondazione di Ricerca e Cura ‘Giovanni Paolo II’, Catholic University of Sacred Heart, 86100 Campobasso, Italy, Radiotherapy Unit, Fondazione di Ricerca e Cura ‘Giovanni Paolo II’, Catholic University of Sacred Heart, 86100 Campobasso, Italy, Department of Radiation Oncology, CRO‑IRCCS, National Cancer Institute, 33081 Aviano, Italy, Radiation Oncology Unit, Bellaria Hospital, 40139 Bologna, Italy, Department of Radiation Oncology, Black Lion Hospital, Addis Ababa 9086, Ethiopia, Radiation Oncology Department, United Hospital Limited, Gulshan, Dhaka 1212, Bangladesh

Copyright: © Buwenge et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 5939-5945
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Published online on: September 4, 2018

https://doi.org/10.3892/ol.2018.9389
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Abstract

The purpose of the present study was to propose an optimized 2D technique (2D‑conformal) for radiotherapy (RT) of pancreatic cancer (CaP). This technique is based on double simulation which resolves the problems of radiographic image distortion. Five patients with locally advanced CaP were identified and enrolled. Treatment planning was simulated in 3 different ways: Two dimensional‑standard (2D‑SRT), 2D‑conformal (2D‑CRT), and three dimensional‑conformal (3D‑CRT) techniques for 10 MV LINAC. Simulation for a cobalt machine was also performed using only the 2D techniques. 2D‑SRT technique was planned with fields definition based on anatomical landmarks (bone and duodenum). 3D‑CRT was planned with standard virtual simulation technique, and 3D dose evaluation and optimization. 2D‑CRT technique was based on manual information transfer from a diagnostic CT‑scan to simulation radiograms. To eliminate the X‑ray image distortion, a double simulation was employed and the profile of the GTV was delineated on radiographs bearing the simulator isocenter into the target center. Concerning target irradiation of either LINAC (10 MV) or cobalt source, the PTV constraints (ICRU 62) were met in all patients (Dmin >95%, Dmax <107%) with all techniques (2D‑SRT, 3D‑CRT, 2D‑CRT). For organs at risk irradiation, in terms of Dmax to both duodenum and spinal cord, similar results were recorded with all techniques using the LINAC (10 MV). Liver and kidneys Dmean gradually improved from 2D‑SRT to 2D‑CRT and 3D‑CRT. The 2D‑CRT compared to 2D‑SRT technique, halved the average dose to the liver and reduced to about 1/3 the average dose to the kidneys. With the cobalt source, using the 2D‑CRT produced a reduction of Dmean to the kidneys (median from 30.7 to 16.9%) and liver (median from 33.4 to 22.3%) compared to 2D‑SRT. This analysis showed better planning results in RT treatment of CaP while using a 2D‑CRT compared to 2D‑SRT technique and therefore presents an example for optimized 2D RT use.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Feasibility of 2D‑conformal radiotherapy for pancreatic carcinoma

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