Skip to main content
Top
Published in: Radiation Oncology 1/2022

Open Access 01-12-2022 | Radiotherapy | Research

Effect of stomach size on organs at risk in pancreatic stereotactic body radiotherapy

Authors: Osamu Tanaka, Takuya Taniguchi, Kousei Adachi, Shuto Nakaya, Takuji Kiryu, Akira Ukai, Chiyoko Makita, Masayuki Matsuo

Published in: Radiation Oncology | Issue 1/2022

Login to get access

Abstract

Background

In clinical practice, the organs at risk (OARs) should be carefully determined when performing pancreatic stereotactic body radiotherapy (SBRT). We conducted a simulation study to examine the effect of the stomach size on the radiation dose to the OARs when performing pancreatic SBRT.

Methods

Twenty-five cases were included in this study. Pancreatic head and body tumors were 2-cm-sized pseudotumors, which were included as gross target volume (GTV) contours. The stomach, pancreas, small intestine, liver, kidneys, and spinal cord were considered as the OARs. The prescription dose for planning target volume (PTV) was 40 Gy/5fx, and the dose limit for the OARs was determined. The dose to X% of the OAR volume at X values of 0.1, 5.0, and 10.0 cc (DX) and the percentage of the OAR volume that received more than X Gy were recorded.

Results

In terms of the radiation dose to the pancreatic body tumors, the stomach size was positively correlated with a dose of D10cc [correlation coefficient (r) = 0.5516) to the stomach. The r value between the radiation dose to the pancreatic head tumor and the stomach size was 0.3499. The stomach size and radiation dose to the head and body of the pancreas were positively correlated (pancreatic head D10cc: r = 0.3979, pancreatic body D10cc: r = 0.3209). The larger the stomach, the larger the radiation dose to the healthy portion of the pancreas outside the PTV.

Conclusions

When performing pancreatic SBRT, the dose to the OARs depends on the stomach size. Reducing the dose to the stomach and pancreas can be achieved by shrinking the stomach.
Literature
1.
go back to reference de Geus SWL, Eskander MF, Kasumova GG, Ng SC, Kent TS, Mancias JD, et al. Stereotactic body radiotherapy for unresected pancreatic cancer: a nationwide review. Cancer. 2017;123:4158–67.CrossRef de Geus SWL, Eskander MF, Kasumova GG, Ng SC, Kent TS, Mancias JD, et al. Stereotactic body radiotherapy for unresected pancreatic cancer: a nationwide review. Cancer. 2017;123:4158–67.CrossRef
2.
go back to reference Krishnan S, Chadha AS, Suh Y, Chen HC, Rao A, Das P, et al. Focal radiation therapy dose escalation improves overall survival in locally advanced pancreatic cancer patients receiving induction chemotherapy and consolidative chemoradiation. Int J Radiat Oncol Biol Phys. 2016;94:755–65.CrossRef Krishnan S, Chadha AS, Suh Y, Chen HC, Rao A, Das P, et al. Focal radiation therapy dose escalation improves overall survival in locally advanced pancreatic cancer patients receiving induction chemotherapy and consolidative chemoradiation. Int J Radiat Oncol Biol Phys. 2016;94:755–65.CrossRef
3.
go back to reference Goldsmith C, Plowman PN, Green MM, Dale RG, Price PM. Stereotactic ablative radiotherapy (SABR) as primary, adjuvant, consolidation and re-treatment option in pancreatic cancer: scope for dose escalation and lessons for toxicity. Radiat Oncol. 2018;13:204.CrossRef Goldsmith C, Plowman PN, Green MM, Dale RG, Price PM. Stereotactic ablative radiotherapy (SABR) as primary, adjuvant, consolidation and re-treatment option in pancreatic cancer: scope for dose escalation and lessons for toxicity. Radiat Oncol. 2018;13:204.CrossRef
4.
go back to reference Reyngold M, Parikh P, Crane CH. Ablative radiation therapy for locally advanced pancreatic cancer: techniques and results. Radiat Oncol. 2019;14:95.CrossRef Reyngold M, Parikh P, Crane CH. Ablative radiation therapy for locally advanced pancreatic cancer: techniques and results. Radiat Oncol. 2019;14:95.CrossRef
5.
go back to reference Loi M, Magallon-Baro A, Suker M, van Eijck C, Sharma A, Hoogeman M, et al. Pancreatic cancer treated with SBRT: effect of anatomical interfraction variations on dose to organs at risk. Radiother Oncol. 2019;134:67–73.CrossRef Loi M, Magallon-Baro A, Suker M, van Eijck C, Sharma A, Hoogeman M, et al. Pancreatic cancer treated with SBRT: effect of anatomical interfraction variations on dose to organs at risk. Radiother Oncol. 2019;134:67–73.CrossRef
6.
go back to reference Niedzielski JS, Liu Y, Ng SSW, Martin RM, Perles LA, Beddar S, et al. Dosimetric uncertainties resulting from interfractional anatomic variations for patients receiving pancreas stereotactic body radiation therapy and cone beam computed tomography image guidance. Int J Radiat Oncol Biol Phys. 2021;111:1298–309.CrossRef Niedzielski JS, Liu Y, Ng SSW, Martin RM, Perles LA, Beddar S, et al. Dosimetric uncertainties resulting from interfractional anatomic variations for patients receiving pancreas stereotactic body radiation therapy and cone beam computed tomography image guidance. Int J Radiat Oncol Biol Phys. 2021;111:1298–309.CrossRef
7.
go back to reference Mazzarotto R, Simoni N, Guariglia S, Rossi G, Micera R, De Robertis R, et al. Dosimetric feasibility study of dose escalated Stereotactic Body Radiation Therapy (SBRT) in locally advanced pancreatic cancer (LAPC) patients: it is time to raise the bar. Front Oncol. 2020;10: 600940.CrossRef Mazzarotto R, Simoni N, Guariglia S, Rossi G, Micera R, De Robertis R, et al. Dosimetric feasibility study of dose escalated Stereotactic Body Radiation Therapy (SBRT) in locally advanced pancreatic cancer (LAPC) patients: it is time to raise the bar. Front Oncol. 2020;10: 600940.CrossRef
8.
go back to reference Thomas TO, Hasan S, Small W Jr, Herman JM, Lock M, Kim EY, et al. The tolerance of gastrointestinal organs to stereotactic body radiation therapy: what do we know so far? J Gastrointest Oncol. 2014;5:236–46.PubMedPubMedCentral Thomas TO, Hasan S, Small W Jr, Herman JM, Lock M, Kim EY, et al. The tolerance of gastrointestinal organs to stereotactic body radiation therapy: what do we know so far? J Gastrointest Oncol. 2014;5:236–46.PubMedPubMedCentral
9.
go back to reference Plichta K, Camden N, Furqan M, Hejleh TA, Clamon GH, Zhang J, et al. SBRT to adrenal metastases provides high local control with minimal toxicity. Adv Radiat Oncol. 2017;2:581–7.CrossRef Plichta K, Camden N, Furqan M, Hejleh TA, Clamon GH, Zhang J, et al. SBRT to adrenal metastases provides high local control with minimal toxicity. Adv Radiat Oncol. 2017;2:581–7.CrossRef
10.
go back to reference Minn AY, Koong AC, Chang DT. Stereotactic body radiation therapy for gastrointestinal malignancies. Front Radiat Ther Oncol. 2011;43:412–27.CrossRef Minn AY, Koong AC, Chang DT. Stereotactic body radiation therapy for gastrointestinal malignancies. Front Radiat Ther Oncol. 2011;43:412–27.CrossRef
11.
go back to reference Campbell WG, Jones BL, Schefter T, Goodman KA, Miften M. An evaluation of motion mitigation techniques for pancreatic SBRT. Radiother Oncol. 2017;124:168–73.CrossRef Campbell WG, Jones BL, Schefter T, Goodman KA, Miften M. An evaluation of motion mitigation techniques for pancreatic SBRT. Radiother Oncol. 2017;124:168–73.CrossRef
12.
go back to reference Tyagi N, Liang J, Burleson S, Subashi E, Scripes PG, Tringale KR, et al. Feasibility of ablative stereotactic body radiation therapy of pancreas cancer patients on a 1.5 tesla magnetic resonance-linac system using abdominal compression. Phys Imaging Radiat Oncol. 2021;19:53–9.CrossRef Tyagi N, Liang J, Burleson S, Subashi E, Scripes PG, Tringale KR, et al. Feasibility of ablative stereotactic body radiation therapy of pancreas cancer patients on a 1.5 tesla magnetic resonance-linac system using abdominal compression. Phys Imaging Radiat Oncol. 2021;19:53–9.CrossRef
13.
go back to reference Tanaka O, Sugiyama A, Omatsu T, Tawada M, Makita C, Matsuo M. Hemostasis radiotherapy for inoperable gastric cancer: a pilot study. Br J Radiol. 2020;93:20190958.CrossRef Tanaka O, Sugiyama A, Omatsu T, Tawada M, Makita C, Matsuo M. Hemostasis radiotherapy for inoperable gastric cancer: a pilot study. Br J Radiol. 2020;93:20190958.CrossRef
14.
go back to reference Tanaka O, Taniguchi T, Ono K, Nakaya S, Makita C, Kiryu T, et al. Adrenal stereotactic body radiation therapy: effects of a full and empty stomach on radiation dose to organs at risk. Onkologia I Radiotherapia. 2021;15:11–7. Tanaka O, Taniguchi T, Ono K, Nakaya S, Makita C, Kiryu T, et al. Adrenal stereotactic body radiation therapy: effects of a full and empty stomach on radiation dose to organs at risk. Onkologia I Radiotherapia. 2021;15:11–7.
15.
go back to reference Tanaka O, Ono K, Taniguchi T, Sakamoto N, Kiryu N, Makita C, et al. Hemostasis irradiation for gastric cancer: comparison of whole and partial stomach irradiation in the liver and kidney. Onkologia I Radioterapia. 2020;14:1–5. Tanaka O, Ono K, Taniguchi T, Sakamoto N, Kiryu N, Makita C, et al. Hemostasis irradiation for gastric cancer: comparison of whole and partial stomach irradiation in the liver and kidney. Onkologia I Radioterapia. 2020;14:1–5.
16.
go back to reference Furman MJ, Whalen GF, Shah SA, Kadish SP. Gastric perforation following stereotactic body radiation therapy of hepatic metastasis from colon cancer. Pract Radiat Oncol. 2013;3:40–4.CrossRef Furman MJ, Whalen GF, Shah SA, Kadish SP. Gastric perforation following stereotactic body radiation therapy of hepatic metastasis from colon cancer. Pract Radiat Oncol. 2013;3:40–4.CrossRef
17.
go back to reference Palacios MA, Bohoudi O, Bruynzeel AME, de Koste JR, Cobussen P, Slotman BJ, et al. Role of daily plan adaptation in MR-guided stereotactic ablative radiation therapy for adrenal metastases. Int J Radiat Oncol Biol Phys. 2018;102:426–33.CrossRef Palacios MA, Bohoudi O, Bruynzeel AME, de Koste JR, Cobussen P, Slotman BJ, et al. Role of daily plan adaptation in MR-guided stereotactic ablative radiation therapy for adrenal metastases. Int J Radiat Oncol Biol Phys. 2018;102:426–33.CrossRef
18.
go back to reference Walter F, Freislederer P, Belka C, Heinz C, Söhn M, Roeder F. Evaluation of daily patient positioning for radiotherapy with a commercial 3D surface-imaging system (Catalyst™). Radiat Oncol. 2016;11:154.CrossRef Walter F, Freislederer P, Belka C, Heinz C, Söhn M, Roeder F. Evaluation of daily patient positioning for radiotherapy with a commercial 3D surface-imaging system (Catalyst™). Radiat Oncol. 2016;11:154.CrossRef
19.
go back to reference Gregucci F, Fiorentino A, Mazzola R, Ricchetti F, Bonaparte I, Surgo A, et al. Radiomic analysis to predict local response in locally advanced pancreatic cancer treated with stereotactic body radiation therapy. Radiol Med. 2022;127:100–7.CrossRef Gregucci F, Fiorentino A, Mazzola R, Ricchetti F, Bonaparte I, Surgo A, et al. Radiomic analysis to predict local response in locally advanced pancreatic cancer treated with stereotactic body radiation therapy. Radiol Med. 2022;127:100–7.CrossRef
Metadata
Title
Effect of stomach size on organs at risk in pancreatic stereotactic body radiotherapy
Authors
Osamu Tanaka
Takuya Taniguchi
Kousei Adachi
Shuto Nakaya
Takuji Kiryu
Akira Ukai
Chiyoko Makita
Masayuki Matsuo
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2022
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-022-02107-1

Other articles of this Issue 1/2022

Radiation Oncology 1/2022 Go to the issue