{"title":"根据肿瘤与胃肠道之间的最短距离，使用每日计算机断层扫描图像预测胰腺癌症立体定向身体放射治疗的每日胃肠道剂量。","authors":"Yusuke Uchinami, Takahiro Kanehira, Keiji Nakazato, Yoshihiro Fujita, Fuki Koizumi, Shuhei Takahashi, Manami Otsuka, Koichi Yasuda, Hiroshi Taguchi, Kentaro Nishioka, Naoki Miyamoto, Kohei Yokokawa, Ryusuke Suzuki, Keiji Kobashi, Keita Takahashi, Norio Katoh, Hidefumi Aoyama","doi":"10.1259/bjro.20230043","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to investigate whether daily computed tomography (CT) images could predict the daily gastroduodenal, small intestine, and large intestine doses of stereotactic body radiation therapy (SBRT) for pancreatic cancer based on the shortest distance between the gross tumor volume (GTV) and gastrointestinal (GI) tract.</p><p><strong>Methods: </strong>Twelve patients with pancreatic cancer received SBRT of 40 Gy in five fractions. We recalculated the reference clinical SBRT plan (PLAN<sub>ref</sub>) using daily CT images and calculated the shortest distance from the GTV to each GI tract. The maximum dose delivered to 0.5 cc (D<sub>0.5cc</sub>) was evaluated for each planning at-risk volume of the GI tract. Spearman's correlation test was used to determine the association between the daily change in the shortest distance (Δshortest distance) and the ratio of ΔD<sub>0.5cc</sub> dose to D<sub>0.5cc</sub> dose in PLAN<sub>ref</sub> (ΔD<sub>0.5cc</sub>/PLAN<sub>ref</sub>) for quantitative analysis.</p><p><strong>Results: </strong>The median shortest distance in PLAN<sub>ref</sub> was 0 mm in the gastroduodenum (interquartile range, 0-2.7), 16.7 mm in the small intestine (10.0-23.7), and 16.7 mm in the large intestine (8.3-28.1 mm). The D<sub>0.5cc</sub> of PLAN<sub>ref</sub> in the gastroduodenum was >30 Gy in all patients, with 10 (83.3%) having the highest dose. A significant association was found between the Δshortest distance and ΔD<sub>0.5cc</sub>/ PLAN<sub>ref</sub> in the small or large intestine (<i>p</i> < 0.001) but not in the gastroduodenum (<i>p</i> = 0.404).</p><p><strong>Conclusions: </strong>The gastroduodenum had a higher D<sub>0.5cc</sub> and predicting the daily dose was difficult. Daily dose calculations of the GI tract are recommended for safe SBRT.</p><p><strong>Advances in knowledge: </strong>This study aimed to predict the daily doses in SBRT for pancreatic cancer from the shortest distance between the GTV and the gastrointestinal tract.Daily changes in the shortest distance can predict the daily dose to the small or large intestines, but not to the gastroduodenum.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630971/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predicting the daily gastrointestinal doses of stereotactic body radiation therapy for pancreatic cancer based on the shortest distance between the tumor and the gastrointestinal tract using daily computed tomography images.\",\"authors\":\"Yusuke Uchinami, Takahiro Kanehira, Keiji Nakazato, Yoshihiro Fujita, Fuki Koizumi, Shuhei Takahashi, Manami Otsuka, Koichi Yasuda, Hiroshi Taguchi, Kentaro Nishioka, Naoki Miyamoto, Kohei Yokokawa, Ryusuke Suzuki, Keiji Kobashi, Keita Takahashi, Norio Katoh, Hidefumi Aoyama\",\"doi\":\"10.1259/bjro.20230043\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>We aimed to investigate whether daily computed tomography (CT) images could predict the daily gastroduodenal, small intestine, and large intestine doses of stereotactic body radiation therapy (SBRT) for pancreatic cancer based on the shortest distance between the gross tumor volume (GTV) and gastrointestinal (GI) tract.</p><p><strong>Methods: </strong>Twelve patients with pancreatic cancer received SBRT of 40 Gy in five fractions. We recalculated the reference clinical SBRT plan (PLAN<sub>ref</sub>) using daily CT images and calculated the shortest distance from the GTV to each GI tract. The maximum dose delivered to 0.5 cc (D<sub>0.5cc</sub>) was evaluated for each planning at-risk volume of the GI tract. Spearman's correlation test was used to determine the association between the daily change in the shortest distance (Δshortest distance) and the ratio of ΔD<sub>0.5cc</sub> dose to D<sub>0.5cc</sub> dose in PLAN<sub>ref</sub> (ΔD<sub>0.5cc</sub>/PLAN<sub>ref</sub>) for quantitative analysis.</p><p><strong>Results: </strong>The median shortest distance in PLAN<sub>ref</sub> was 0 mm in the gastroduodenum (interquartile range, 0-2.7), 16.7 mm in the small intestine (10.0-23.7), and 16.7 mm in the large intestine (8.3-28.1 mm). The D<sub>0.5cc</sub> of PLAN<sub>ref</sub> in the gastroduodenum was >30 Gy in all patients, with 10 (83.3%) having the highest dose. A significant association was found between the Δshortest distance and ΔD<sub>0.5cc</sub>/ PLAN<sub>ref</sub> in the small or large intestine (<i>p</i> < 0.001) but not in the gastroduodenum (<i>p</i> = 0.404).</p><p><strong>Conclusions: </strong>The gastroduodenum had a higher D<sub>0.5cc</sub> and predicting the daily dose was difficult. Daily dose calculations of the GI tract are recommended for safe SBRT.</p><p><strong>Advances in knowledge: </strong>This study aimed to predict the daily doses in SBRT for pancreatic cancer from the shortest distance between the GTV and the gastrointestinal tract.Daily changes in the shortest distance can predict the daily dose to the small or large intestines, but not to the gastroduodenum.</p>\",\"PeriodicalId\":72419,\"journal\":{\"name\":\"BJR open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630971/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJR open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1259/bjro.20230043\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJR open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1259/bjro.20230043","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Predicting the daily gastrointestinal doses of stereotactic body radiation therapy for pancreatic cancer based on the shortest distance between the tumor and the gastrointestinal tract using daily computed tomography images.
Objectives: We aimed to investigate whether daily computed tomography (CT) images could predict the daily gastroduodenal, small intestine, and large intestine doses of stereotactic body radiation therapy (SBRT) for pancreatic cancer based on the shortest distance between the gross tumor volume (GTV) and gastrointestinal (GI) tract.
Methods: Twelve patients with pancreatic cancer received SBRT of 40 Gy in five fractions. We recalculated the reference clinical SBRT plan (PLANref) using daily CT images and calculated the shortest distance from the GTV to each GI tract. The maximum dose delivered to 0.5 cc (D0.5cc) was evaluated for each planning at-risk volume of the GI tract. Spearman's correlation test was used to determine the association between the daily change in the shortest distance (Δshortest distance) and the ratio of ΔD0.5cc dose to D0.5cc dose in PLANref (ΔD0.5cc/PLANref) for quantitative analysis.
Results: The median shortest distance in PLANref was 0 mm in the gastroduodenum (interquartile range, 0-2.7), 16.7 mm in the small intestine (10.0-23.7), and 16.7 mm in the large intestine (8.3-28.1 mm). The D0.5cc of PLANref in the gastroduodenum was >30 Gy in all patients, with 10 (83.3%) having the highest dose. A significant association was found between the Δshortest distance and ΔD0.5cc/ PLANref in the small or large intestine (p < 0.001) but not in the gastroduodenum (p = 0.404).
Conclusions: The gastroduodenum had a higher D0.5cc and predicting the daily dose was difficult. Daily dose calculations of the GI tract are recommended for safe SBRT.
Advances in knowledge: This study aimed to predict the daily doses in SBRT for pancreatic cancer from the shortest distance between the GTV and the gastrointestinal tract.Daily changes in the shortest distance can predict the daily dose to the small or large intestines, but not to the gastroduodenum.
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