Radiobiological evaluation of the 3D-conformal radiotherapy of the pancreas cancer: results of a comparative study between filed-in-filed technique and the use of conventional wedges

Farzaneh Allaveisi


Introduction: This study is conducted to compare the radiobiological parameters of two 3D conformal radiotherapy (3DCRT) techniques including the wedge-based three fields (W3F) and field-in-field (FIF) used for treatment planning of the pancreas cancer.
Methods: Twenty-five patients with the pancreatic cancer were selected for this study. Treatment planning of the all cases was done using the Isogray treatment planning system (TPS). The mean dose and equivalent uniform dose (EUD) to the PTV and critical structures such as the liver, kidneys, and spinal cord were obtained from the dose–volume histograms (DVHs) and compared between the W3F and FIF techniques.
Results: Evaluation of the V30Gy and V28Gy parameters respectively for the liver and kidneys revealed the larger irradiated volumes in the W3F technique compared with the FIF technique. The EUD and mean dose values of the PTV in the FIF were slightly (P > 0.05) lower than the W3F plan. Furthermore, it was observed that the FIF method significantly (P < 0.05) produces lower levels of the EUD and mean dose for the organs at risk (OARs) in comparison with the W3F. In particular, the EUDs of the bilateral kidneys and spinal cord in the FIF plans were significantly (P < 0.05) reduced by 38% and 8.02%, respectively, as compared to the W3F technique.
Conclusion: The FIF method has the advantage in terms of reducing the dose received by the critical OARs. This outcome consequently leads to decreasing the radiobiological complications. To conclude, the FIF can be considered as a potential substitute for the W3F technique in the clinical situations of the pancreatic malignancies.

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