Ablative 5-Fraction CT vs. MR-Guided Pancreatic SBRT: Evaluation of Interfraction Anatomic Changes on Dosimetric Constraints

M. D. Chuong, A. Fellows, A. E. Rzepczynski, A. Kaiser,M. D. Hall,R. Kotecha, D. Alvarez, N. Bassiri-Gharb, A. Gutierrez, J. McCulloch,K. E. Mittauer,N. McAllister

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS（2023）

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Abstract

This isthe first evaluation of IAC effects on predicted GI OAR dose for 5-fx CT- vs. MR-guided SBRT. Although VMAT arcs facilitated higher target coverage in the initial CT plans, GI OAR constraint violations were observed in 85-88% of CT/MR plans. Although on-table adaptive replanning is routine on MR-guided Linacs it is not commonly available on CT-guided Linacs. As such, ablative 5-fx SBRT delivered with CT guidance is expected to result in significant toxicity due to exceeding GI OAR constraints for most delivered fractions.

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Key words

pancreatic sbrt,interfraction anatomic changes,dosimetric constraints,mr-guided

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