ArticleAdvances in radiation oncology
Dose Escalation for Pancreas SBRT: Potential and Limitations of using Daily Online Adaptive Radiation Therapy and an Iterative Isotoxicity Automated Planning Approach.
Article in Advances in radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 6 citations in OpenAlex.
- Workflow and dosimetric results for direct-to-unit single-fraction adaptive lung SBRT delivered on the ONE-STOP prospective pilot clinical trial.Clinical and translational radiation oncology · 2026Article
- Practical Considerations in the Radiotherapy Treatment Planning for SBRT Pancreas Program.Current oncology (Toronto, Ont.) · 2026Review
- Development of CBCT-Guided Online Adaptive Radiotherapy.Cancers · 2026Review
- Evaluation of the efficacy of plan adaptation in stereotactic body proton therapy for pancreatic cancer.Journal of applied clinical medical physics · 2026Article
- Article
- Evolving Paradigms in the Treatment of Oligometastatic Pancreatic Ductal Adenocarcinoma.Journal of gastrointestinal cancer · 2025Review
- Current status and upcoming developments for online adaptive proton therapy enabling a closed feedback loop for near real-time adaptation.Frontiers in oncology · 2025Review
- Article
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Authors and funding
15 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To determine the dosimetric limitations of daily online adaptive pancreas stereotactic body radiation treatment by using an automated dose escalation approach. Methods and Materials: We collected 108 planning and daily computed tomography (CT) scans from 18 patients (18 patients × 6 CT scans) who received 5-fraction pancreas stereotactic body radiation treatment at MD Anderson Cancer Center. Dose metrics from the original non-dose-escalated clinical plan (non-DE), the dose-escalated plan created on the original planning CT (DE-ORI), and the dose-escalated plan created on daily adaptive radiation therapy CT (DE-ART) were analyzed. We developed a dose-escalation planning algorithm within the radiation treatment planning system to automate the dose-escalation planning process for efficiency and consistency. In this algorithm, the prescription dose of the dose-escalation plan was escalated before violating any organ-at-risk (OAR) dose constraint. Dose metrics for 3 targets (gross target volume [GTV], tumor vessel interface [TVI], and dose-escalated planning target volume [DE-PTV]) and 9 OARs (duodenum, large bowel, small bowel, stomach, spinal cord, kidneys, liver, and skin) for the 3 plans were compared. Furthermore, we evaluated the effectiveness of the online adaptive dose-escalation planning process by quantifying the effect of the interfractional dose distribution variations among the DE-ART plans. Results: The median D Conclusions: Most patients require daily adaptation of the radiation planning process to maximally escalate delivered dose to the pancreatic tumor without exceeding OAR constraints. Using our automated approach, patients can receive higher target dose than standard of care without violating OAR constraints.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.