ArticlePractical radiation oncology
Quantifying Allowable Motion to Achieve Safe Dose Escalation in Pancreatic SBRT.
Article in Practical radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Automated treatment planning as a dose escalation strategy for stereotactic radiation therapy in pancreatic cancer.Journal of applied clinical medical physics · 2020Trial
- Effect of tumor size on motion tracking and dosimetric accuracy using Radixact Synchrony.Journal of radiation research · 2026Article
- Dosimetric comparison of multiple SBRT delivery platforms for pancreatic cancer.European journal of medical research · 2024Article
- Assessment of interfraction dose variation in pancreas SBRT using daily simulation MR images.Physical and engineering sciences in medicine · 2023Article
- Intrafractional accuracy and efficiency of a surface imaging system for deep inspiration breath hold during ablative gastrointestinal cancer treatment.Journal of applied clinical medical physics · 2022Article
- Study on Motion Management of Pancreatic Cancer Treated by CyberKnife.Frontiers in oncology · 2021Article
- Accuracy and efficiency of respiratory gating comparable to deep inspiration breath hold for pancreatic cancer treatment.Journal of applied clinical medical physics · 2021Article
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Authors and funding
7 authors.
Funding
Abstract
purposeTumor motion plays a key role in the safe delivery of stereotactic body radiation therapy (SBRT) for pancreatic cancer. The purpose of this study was to use tumor motion measured in patients to establish limits on motion magnitude for safe delivery of pancreatic SBRT and to help guide motion-management decisions in potential dose-escalation scenarios. METHODS AND MATERIALS: Using 91 sets of pancreatic tumor motion data, we calculated the motion-convolved dose of the gross tumor volume, duodenum, and stomach for 25 patients with pancreatic cancer. We derived simple linear or quadratic models relating motion to changes in dose and used these models to establish the maximum amount of motion allowable while satisfying error thresholds on key dose metrics. In the same way, we studied the effects of dose escalation and tumor volume on allowable motion.
resultsIn our patient cohort, the mean (range) allowable motion for 33, 40, and 50 Gy to the planning target volume was 11.9 (6.3-22.4), 10.4 (5.2-19.1), and 9.0 (4.2-16.0) mm, respectively. The maximum allowable motion decreased as the dose was escalated and was smaller in patients with larger tumors. We found significant differences in allowable motion between the different plans, suggesting a patient-specific approach to motion management is possible.
conclusionsThe effects of motion on pancreatic SBRT are highly variable among patients, and there is potential to allow more motion in certain patients, even in dose-escalated scenarios. In our dataset, a conservative limit of 6.3 mm would ensure safe treatment of all patients treated to 33 Gy in 5 fractions.
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