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Table 6 Duodenal dosimetry and treatment factors for patients with Grade 3+ toxicity

From: Stereotactic ablative radiotherapy (SABR) as primary, adjuvant, consolidation and re-treatment option in pancreatic cancer: scope for dose escalation and lessons for toxicity

Grade 3+ Toxicity Treatment Factors Duodenal Dosimetry
Fids PTV Prescribed Dose Dur’n D0.035 cc D1.0 cc D5.0 cc D10.0 cc V15 Gy V20 Gy
ACUTE
 Grade 3 pain 4 39.84 cc 30.0 Gy 3 fractions 3 days 33.9 Gy* 25.4 Gy 15.8 Gy 12.8 Gy* 5.9 cc 2.5 cc
 Grade 3 fatigue 3 44.22 cc 30.0 Gy 3 fractions 3 days 34.9 Gy* 27.9 Gy 20.5 Gy* 16.2 Gy* 12.3 cc 5.4 cc
 Grade 3 obstructive jaundice 4 119.57 cc 21.0 Gy 3 fractions 3 days 23.8 Gy* 22.6 Gy 21.1 Gy* 19.6 Gy* 32.2 cc 8.6 cc
LATE
 Grade 4 duodenal stricture 1 20.34 cc 28.5 Gy 3 fractions 5 days 11.2 Gy 8.3 Gy 6.8 Gy 6.2 Gy 0.0 cc 0.0 cc
 Grade 4 GI bleed 1 83.49 cc 27.0 Gy 3 fractions 5 days 29.3 Gy* 28.3 Gy 26.2 Gy* 23.9 Gy* 39.1 cc 19.4 cc
 Grade 4 GI bleed 3 109.31 cc 22.0 Gy 3 fractions 3 days 24.2 Gy* 23.2 Gy 22.5 Gy* 21.8 Gy* 63.3 cc 24.3 cc
 Grade 4 duodenal stricture 3 104.25 cc 27.0 Gy 3 fractions 3 days 31.6 Gy* 29.1 Gy 26.0 Gy* 21.8 Gy* 24.2 cc 12.8 cc
  1. *Duodenal planning dosimetry exceeded institution preferred 3 fraction constraints. † single fiducial conferring anticipated increased risk of duodenal complications [47]