{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:19:00Z","timestamp":1786976340039,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T00:00:00Z","timestamp":1602806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the feasibility of automated stereotactic volumetric modulated arc therapy (SBRT\u2010VMAT) planning using a simultaneous integrated boost (SIB) approach as a dose escalation strategy for SBRT in pancreatic cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twelve patients with pancreatic cancer were retrospectively replanned. Dose prescription was 30\u00a0Gy to the planning target volume (PTV) and was escalated up to 50\u00a0Gy to the boost target volume (BTV) using a SIB technique in 5 fractions. All plans were generated by Pinnacle\n                      <jats:sup>3<\/jats:sup>\n                      Autoplanning using 6MV dual\u2010arc VMAT technique for flattened (FF) and flattening filter\u2010free beams (FFF). An overlap volume (OLV) between the PRV duodenum and the PTV was defined to correlate with the ability to boost the BTV. Dosimetric metrics for BTV and PTV coverage, maximal doses for serial OARs, integral dose, conformation numbers, and dose contrast indexes were used to analyze the dosimetric results. Dose accuracy was validated using the PTW Octavius\u20104D phantom together with the 1500 2D\u2010array. Differences between FF and FFF plans were quantified using the Wilcoxon matched\u2010pair signed rank.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Full prescription doses to the 95% of PTV and BTV can be delivered to patients with no OLV. BTV mean dose was &gt;90% of the prescribed doses for all patients at all dose levels. Compared to FF plans, FFF plans showed significant reduced integral doses, larger number of MUs, and reduced beam\u2010on\u2010times up to 51% for the highest dose level. Despite plan complexity, pre\u2010treatment verification reported a gamma pass\u2010rate greater than the acceptance threshold of 95% for all FF and FFF plans for 3%\u20102\u00a0mm criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SIB\u2010SBRT strategy with Autoplanning was dosimetrically feasible. Ablative doses up to 50\u00a0Gy in 5 fractions can be delivered to the BTV for almost all patients respecting all the normal tissue constraints. A prospective clinical trial based on SBRT strategy using SIB\u2010VMAT technique with FFF beams seems to be justified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.13025","type":"journal-article","created":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T07:43:33Z","timestamp":1602834213000},"page":"48-57","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Automated treatment planning as a dose escalation strategy for stereotactic radiation therapy in pancreatic cancer"],"prefix":"10.1002","volume":"21","author":[{"given":"Savino","family":"Cilla","sequence":"first","affiliation":[{"name":"Medical Physics Unit Gemelli Molise Hospital \u2010 Universit\u00e0 Cattolica del Sacro Cuore Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Ianiro","sequence":"additional","affiliation":[{"name":"Medical Physics Unit Gemelli Molise Hospital \u2010 Universit\u00e0 Cattolica del Sacro Cuore Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela","family":"Romano","sequence":"additional","affiliation":[{"name":"Medical Physics Unit Gemelli Molise Hospital \u2010 Universit\u00e0 Cattolica del Sacro Cuore Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Deodato","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit Gemelli Molise Hospital \u2010 Universit\u00e0 Cattolica del Sacro Cuore Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Macchia","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit Gemelli Molise Hospital \u2010 Universit\u00e0 Cattolica del Sacro Cuore Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Viola","sequence":"additional","affiliation":[{"name":"Medical Physics Unit Gemelli Molise Hospital \u2010 Universit\u00e0 Cattolica del Sacro Cuore Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milly","family":"Buwenge","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department DIMES Universit\u00e0 di Bologna \u2010 Ospedale S.Orsola Malpighi Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Cammelli","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department DIMES Universit\u00e0 di Bologna \u2010 Ospedale S.Orsola Malpighi Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pierro","sequence":"additional","affiliation":[{"name":"Radiology Department Gemelli Molise Hospital \u2010 Universit\u00e0 Cattolica del Sacro Cuore Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Valentini","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit Gemelli Molise Hospital \u2010 Universit\u00e0 Cattolica del Sacro Cuore Campobasso Italy"},{"name":"Radiation Oncology Department Fondazione Policlinico Universitario A. 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