Efficacy of Spacers in Radiation Therapy for Locally Advanced Pancreatic Cancer: A Planning Study

Anticancer Res. 2021 Jan;41(1):503-508. doi: 10.21873/anticanres.14801.

Abstract

Background/aim: We aimed to investigate the dosimetric effects of a spacer placed between the pancreas and surrounding gastrointestinal structures in intensity-modulated radiation therapy (IMRT) planning to provide more effective radiation therapy for locally advanced pancreatic cancer (LAPC).

Patients and methods: Treatment planning was performed for six patients with LAPC based on computed tomography images without spacers and with 5-mm or 10-mm spacers virtually inserted under the supervision of a hepatobiliary pancreatic surgeon. The prescription dose was 63 Gy in 28 fractions.

Results: With the exception of one case of pancreatic head cancer, planning target volume receiving ≥95% of the prescribed dose (PTV V95) was achieved by 90% or more by inserting a spacer, and by 95% or more in all 3 cases of pancreatic body and tail cancer by inserting a 10-mm spacer.

Conclusion: IMRT with appropriate spacer placement may help provide high-dose treatment for LAPC and improve associated patient outcomes.

Keywords: Pancreatic cancer; intensity-modulated radiation therapy; planning study; spacer.

MeSH terms

  • Female
  • Humans
  • Male
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Organ Sparing Treatments / instrumentation*
  • Organ Sparing Treatments / methods
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / radiotherapy*
  • Radiotherapy Planning, Computer-Assisted* / methods
  • Radiotherapy* / instrumentation
  • Radiotherapy* / methods
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome