Pancreatic Cancer [[toc]]Field

Field Diagram from RTOG 9704

Head of Pancreas
head

Body of Pancreas
body

Tail of Pancreas
tail

Lateral Field
lateral

Large Field Description

As general guidelines the edges of the large fields are to be defined as follows:
a) superior edge: intervertebral space T10-T11 or mid T11.
b) inferior edge: intervertebral space L3-L4, depending on the preoperative studies.
c) right edge: A margin of 2-3 cm is maintained on preoperative primary tumor extent. In tumors of
the body or tail region the right edge may be moved to a minimum of 2 cm from the right edge of
the vertebral bodies, as long as a margin of 2-3 cm is maintained on preoperative primary tumor
extent, to allow sparing of the right kidney while covering nodal areas at high risk (Fig. 3 or 4,
Appendix VI).
d) left edge: a margin of 2-3 cm from the preoperative primary tumor extent or 2 cm from the left
edge of the vertebral bodies, whichever is most lateral.
e) posterior edge: should split the anterior vertebral bodies in half (Fig. 2, Appendix VI).
f) anterior edge: 1.5-2 cm anterior to anterior aspect of the primary tumor as defined on
preoperative CT scan and at least 3.5-4 cm anterior to the anterior edge of the vertebral bodies,
whichever is most anterior, (or 1.5-2 cm anterior to nodal volumes as reconstructed from CT scan
information and outlined on simulator films [recommended, but not required]).

Boost Fields

A single field reduction, at 45 Gy is required, encompassing the preoperative primary tumor volume
only with a field edge margin of 1.5-2 cm on all fields.

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