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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.

Authors :
Kaučić H
Kosmina D
Schwarz D
Čehobašić A
Leipold V
Pedišić I
Mlinarić M
Lekić M
Šobat H
Mack A
Source :
Current oncology (Toronto, Ont.) [Curr Oncol] 2021 Nov 11; Vol. 28 (6), pp. 4597-4610. Date of Electronic Publication: 2021 Nov 11.
Publication Year :
2021

Abstract

(1) Background: the aims of this study were to determine the total extent of pancreatic cancer's internal motions, using Calypso <superscript>®</superscript> 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 <superscript>®</superscript> for motion management. Planning MSCTs in FB and DBH, and 4D-CTs were performed. Using data from Calypso <superscript>®</superscript> 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 <superscript>®</superscript> -based ITV were compared. (3) Results: significantly larger medians of tumor excursions were found with Calypso <superscript>®</superscript> 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 <superscript>®</superscript> -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.

Details

Language :
English
ISSN :
1718-7729
Volume :
28
Issue :
6
Database :
MEDLINE
Journal :
Current oncology (Toronto, Ont.)
Publication Type :
Academic Journal
Accession number :
34898575
Full Text :
https://doi.org/10.3390/curroncol28060389