An Evaluation of Total Internal Motions of Locally Advanced Pancreatic Cancer during SABR Using Calypso® Extracranial Tracking, and Its Possible Clinical Impact on Motion Management

Current Oncology

Adlan Čehobašić¹  Ivo Pedišić¹  Hrvoje Šobat¹  Dragan Schwarz¹  Matea Lekić¹  Domagoj Kosmina¹  Mihaela Mlinarić¹  Hrvoje Kaučić¹  Vanda Leipold¹  Andreas Mack² 

[1] Specijalna Bolnica, Radiochirurgia Zagreb, Franje Tuđmana 4, 10431 Sveta Nedelja, Croatia;Swiss NeuroRadiosurgery Center, Bürglistrasse 29, 8002 Zürich, Switzerland;

关键词: Calypso^® extracranial tracking;    dose escalation;    LAPC;    motion management;    pancreatic SABR;   

DOI  :  10.3390/curroncol28060389

来源: DOAJ

【 摘 要 】

(1) Background: the aims of this study were to determine the total extent of pancreatic cancer’s internal motions, using Calypso^® extracranial tracking, and to indicate possible clinical advantages of continuous intrafractional fiducial-based tumor motion tracking during SABR. (2) Methods: thirty-four patients were treated with SABR for LAPC using Calypso^® for motion management. Planning MSCTs in FB and DBH, and 4D-CTs were performed. Using data from Calypso^® and 4D-CTs, the movements of the lesions in the CC, AP and LR directions, as well as the volumes of the 4D-CT-based ITV and the volumes of the Calypso^®-based ITV were compared. (3) Results: significantly larger medians of tumor excursions were found with Calypso^® than with 4D-CT: CC: 29 mm (p < 0.001); AP: 14 mm (p < 0.001) and LR: 11 mm (p < 0.039). The median volume of the Calypso^®-based ITV was significantly larger than that of the 4D-CT based ITV (p < 0.001). (4) Conclusion: beside known respiratory-induced internal motions, pancreatic cancer seems to have significant additional motions which should be considered during respiratory motion management. Only direct and continuous intrafractional fiducial-based motion tracking seems to provide complete coverage of the target lesion with the prescribed isodose, which could allow for safe tumor dose escalation.

【 授权许可】

Unknown