Devlin, L., Grocutt, L., Hunter, B., Chemu, H., Duffton, A., McDonald, A., Macleod, N., McLoone, P. and O'Cathail, S. M. (2022) The in-silico feasibility of dose escalated, hypofractionated radiotherapy for rectal cancer. Clinical and Translational Radiation Oncology, 36, pp. 24-30. (doi: 10.1016/j.ctro.2022.06.003) (PMID:35756193) (PMCID:PMC9218294)
![[img]](https://eprints.gla.ac.uk/style/images/fileicons/text.png) |
Text
273107.pdf - Published Version Available under License Creative Commons Attribution. 2MB |
Abstract
Background and purpose: Short course radiotherapy (SCRT) has a low biological prescription dose. Rectal cancer has a dose response relationship and moderate α/β ratio (∼5). We hypothesise hypofractionated dose escalation has radiobiological advantages. We assessed in-silico dose escalation to the primary tumour using a simultaneous integrated boost (SIB) technique. Materials and methods: Patients who had received 25 Gy/5# were enrolled. GTV was macroscopic tumour including lumen. CTVA was GTV + 10 mm. CTVB included elective nodes. PTV_Low was created from CTVF (CTVA + CTVB) + 7 mm. PTV_High (SIB) was GTV + 5 mm margin. OAR were as per RTOG guidelines. Each patient had 4 plans created at increasing dose levels (27.5 Gy, 30 Gy, 32.5 Gy and 35 Gy) to PTV_High. PTV_Low was 25 Gy/5#. 5 test plans were created for each patient in Eclipse™ v15.5 and consisted of 2 VMAT full arcs (6 MV), Varian Truebeam (2.7). Planning objectives were set in the Photon optimiser (PO) and recalculated using Acuros v15.5. A priori feasibility was defined as 90% of plans achieving the planning objectives at 32.5 Gy dose level (EqD2 53.4 Gy). Results: 20 SCRT patients median age 70, F (n = 5), M (n = 15). Rectum level; low (n = 12), mid (n = 3) and upper (n = 5). 100 plans were analysed. Mean volume of PTV_High was 130 cm3 (SD 81.5) and PTV_Low 769.6 cm3 (SD 241.1). 100% plans complied with mandatory planning dose metrics for each structure at the 25 Gy/5# plan and each dose level. Conclusion: Hypofractionated dose escalation to the primary tumour up to 35 Gy/5# is technically feasible in rectal cancer radiotherapy.
| Item Type: | Articles |
|---|---|
| Additional Information: | Funding for research post held by LD is provided by the Beatson Cancer Charity and by CRUK RadNet Glasgow (C16583/A28803). LG funding is provided by CRUK RadNet Glasgow (C16583/A28803). SMO’C is a CRUK funded clinical senior lecturer at the Institute of Cancer Sciences (grant number CAN-RES-UK (C7932/A25142). AD funding is provided by the Beatson Cancer Charity. Funding for statistical support from PM was provided by the Beatson Cancer Charity. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McLoone, Mr Philip and Duffton, Ms Aileen and O'Cathail, Dr Sean and Grocutt, Dr Laura |
| Authors: | Devlin, L., Grocutt, L., Hunter, B., Chemu, H., Duffton, A., McDonald, A., Macleod, N., McLoone, P., and O'Cathail, S. M. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health |
| Journal Name: | Clinical and Translational Radiation Oncology |
| Publisher: | Elsevier |
| ISSN: | 2405-6308 |
| ISSN (Online): | 2405-6308 |
| Published Online: | 11 June 2022 |
| Copyright Holders: | Copyright © 2022 The Authors |
| First Published: | First published in Clinical and Translational Radiation Oncology 36:24-30 |
| Publisher Policy: | Reproduced under a Creative Commons License |
University Staff: Request a correction | Enlighten Editors: Update this record
Funder and Project Information
Funder and Project Information