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Dose-Response to Different Radiochemotherapy Regimens in Locally Advanced Pancreatic Cancer

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XV Mediterranean Conference on Medical and Biological Engineering and Computing – MEDICON 2019 (MEDICON 2019)

Part of the book series: IFMBE Proceedings ((IFMBE,volume 76))

Abstract

Conformal radiation therapy (RT) delivered concomitantly with chemotherapy including 5-fluorouracil (5-FU) or Gemcitabine (GEM) is a common treatment for patients with unresectable locally advanced pancreatic tumors. In this study, the Poisson model describing tumor response to these two treatment options was derived. Clinical data was retrieved from reports published from 1990 to 2015. Dosimetric and clinical data from 1196 patients treated with RT with concurrent 5-FU or GEM were gathered. RT doses ranging from 3.6–64.8 Gy, delivered in fractions of 1.2–8 Gy, were converted to a 2 Gy fractionation scheme using the Biological Effective Dose concept. The parameters of the Poisson-Linear-Quadratic-Time model were derived using genetic algorithm optimization to minimize the least-square fitting error and a local search was then made using the maximum likelihood method. The goodness of the fit was assessed using the Pearson χ2-test. For RT+5-FU, D50 was 59.8 Gy, γ was 1.3, α/β was 3.2, Tpot was 18.6 days and Tk was 25.0 days. For RT+GEM, D50 was 54.5 Gy, γ was 1.4, α/β was 4.6, Tpot was 34.2 days and Tk was 37.2 days. As expected, RT+GEM showed higher efficacy than RT+5-FU. A RT dose-response effect was obtained showing that treatment strategies allowing a dose-escalation in pancreas tumors should be investigated.

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Acknowledgements

This work was partially funded by project grants UID/CTM/50025/2019, POCI-01-0145-FEDER-028030 and by the Fundação para a Ciência e a Tecnologia under project grant UID/Multi/00308/2019.

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Authors and Affiliations

  1. School of Health, Polytechnic of Porto, Porto, Portugal

    Brígida C. Ferreira & Adriana Gomes

  2. Institute for Systems Engineering and Computers at Coimbra, Coimbra University, Coimbra, Portugal

    Brígida C. Ferreira, Joana Dias & Humberto Rocha

  3. I3N, Physics Department of Aveiro University, Aveiro, Portugal

    Brígida C. Ferreira

  4. CeBER and FEUC, Coimbra University, Coimbra, Portugal

    Joana Dias & Humberto Rocha

  5. Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Panayiotis Mavroidis

  6. Division of Medical Radiation Physics, Karolinska Institutet and Stockholm University, Stockholm, Sweden

    Panayiotis Mavroidis

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  1. Brígida C. Ferreira
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  2. Joana Dias
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Correspondence to Brígida C. Ferreira .

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Editors and Affiliations

  1. University of Coimbra, Coimbra, Portugal

    Jorge Henriques

  2. Universidade do Minho, Braga, Portugal

    Nuno Neves

  3. University of Coimbra, Coimbra, Portugal

    Paulo de Carvalho

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Ferreira, B.C., Dias, J., Gomes, A., Mavroidis, P., Rocha, H. (2020). Dose-Response to Different Radiochemotherapy Regimens in Locally Advanced Pancreatic Cancer. In: Henriques, J., Neves, N., de Carvalho, P. (eds) XV Mediterranean Conference on Medical and Biological Engineering and Computing – MEDICON 2019. MEDICON 2019. IFMBE Proceedings, vol 76. Springer, Cham. https://doi.org/10.1007/978-3-030-31635-8_156

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  • DOI: https://doi.org/10.1007/978-3-030-31635-8_156

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