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000282359 1001_ $$0P:(DE-He78)c05a55723806b3aa6693a6c5a70c73f0$$aBaltazar, Filipa$$b0$$eFirst author$$udkfz
000282359 245__ $$aCarbon-ion Radiotherapy (CIRT) as treatment of pancreatic cancer at HIT: initial radiation plan analysis of the prospective phase II PACK-study.
000282359 260__ $$aAmsterdam [u.a.]$$bElsevier Science$$c2023
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000282359 500__ $$a#EA:E050#LA:E050# / Volume 188, November 2023, 109872
000282359 520__ $$aTo analyze the dose objectives and constraints applied at the prospective phase II PACK-study at Heidelberg ion therapy center (HIT) for different radiobiological models.Treatment plans of 14 patients from the PACK-study were analyzed and recomputed in terms of physical, biological dose and dose-averaged linear energy transfer (LETd). Both LEM-I (local effect model 1) and the adapted NIRS-MKM (microdosimetric kinetic model), were used for relative biological effectiveness (RBE)-weighted dose calculations (DBio|HIT and DBio|NIRS). A new constraint to the gastrointestinal (GI) tract was derived from the National Institute of Radiological Science (NIRS) clinical experience and considered for plan reoptimization (DBio|NIRS-const_48Gy. and DBio|NIRS-const_50.4Gy). The Lyman-Kutcher-Burman (LKB) model of Normal Tissue Complication Probability (NTCP) for GI toxicity endpoints was computed. Furthermore, the computed LETd distribution was evaluated and correlated with Local Control (LC).Only two patients showed a LETd98% in the GTV greater than 44 keV/μm. A HIT-dose constraint to the GI of D 2cm3= 48.6 GyRBEHIT was derived from the NIRS experience, in alternative to the standard at HIT Dmax= 45.6 GyRBEHIT. In comparison with the original DBio|HIT,DBio|NIRS-const_48GyandDBio|NIRS-const_50.4Gy resulted in an increase in the ITV's D98% of 8.7% and 11.3%. The NTCP calculation resulted in a probability for gastrointestinal bleeding of 4.5%, 12.3% and 13.0%, for DBio|NIRS, DBio|NIRS-const_48Gy and DBio|NIRS-const_50.4Gy, respectively.The results indicate that the current standards applied at HIT for CIRT closely align with the Japanese experience. However, to enhance tumor coverage, a more relaxed constraint on the GI tract may be considered. As the PACK-trial progresses, further analyses of various clinical endpoints are anticipated.
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000282359 650_7 $$2Other$$aGastrointestinal toxicity
000282359 650_7 $$2Other$$aPancreatic cancer
000282359 650_7 $$2Other$$aTreatment dose constraints
000282359 650_7 $$2Other$$acarbon ion radiotherapy
000282359 7001_ $$aTessonnier, Thomas$$b1
000282359 7001_ $$aHaberer, Thomas$$b2
000282359 7001_ $$0P:(DE-He78)8714da4e45acfa36ce87c291443a9218$$aDebus, Jürgen$$b3$$udkfz
000282359 7001_ $$0P:(DE-He78)ea5c703d5f5cf5f1c26a34b38a5056dc$$aHerfarth, Klaus$$b4
000282359 7001_ $$0P:(DE-He78)4f5721350bd23340e626cb0340bef47a$$aTawk, Bouchra$$b5$$udkfz
000282359 7001_ $$0P:(DE-HGF)0$$aKnoll, Maximillian$$b6
000282359 7001_ $$0P:(DE-He78)360c5bc2b71a849e35aca747c041dda7$$aAbdollahi, Amir$$b7$$udkfz
000282359 7001_ $$aLiermann, Jakob$$b8
000282359 7001_ $$0P:(DE-He78)8d6c2aceda79e88defe1e8c0fcc39d59$$aMairani, Andrea$$b9$$eLast author$$udkfz
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