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Does electron and p...
Does electron and proton therapy reduce the risk of radiation induced cancer after spinal irradiation for childhood medulloblastoma? A comparative treatment planning study.
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- Mu, Xiangkui (author)
- Umeå universitet,Onkologi
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- Björk-Eriksson, Thomas, 1960 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för särskilda specialiteter, Avdelningen för onkologi,Institute of Selected Clinical Sciences, Department of Oncology
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Nill, Simeon (author)
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Oelfke, Uwe (author)
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- Johansson, Karl-Axel (author)
- Gothenburg University,Göteborgs universitet,Institutionen för särskilda specialiteter, Avdelningen för radiofysik,Institute of Selected Clinical Sciences, Department of Radiation Physics
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- Gagliardi, Giovanna (author)
- Karolinska Institutet
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- Johansson, Lennart (author)
- Umeå universitet,Radiofysik
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- Karlsson, Mikael (author)
- Umeå universitet,Radiofysik
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- Zackrisson, Björn (author)
- Umeå universitet,Onkologi
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(creator_code:org_t)
- 2009-07-08
- 2005
- English.
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In: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 44:6, s. 554-62
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Abstract
Subject headings
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- The aim of this treatment planning comparison study was to explore different spinal irradiation techniques with respect to the risk of late side-effects, particularly radiation-induced cancer. The radiotherapy techniques compared were conventional photon therapy, intensity modulated x-ray therapy (IMXT), conventional electron therapy, intensity/energy modulated electron therapy (IMET) and proton therapy (IMPT).CT images for radiotherapy use from five children, median age 8 and diagnosed with medulloblastoma, were selected for this study. Target volumes and organs at risk were defined in 3-D. Treatment plans using conventional photon therapy, IMXT, conventional electron therapy, IMET and IMPT were set up. The probability of normal tissue complication (NTCP) and the risk of cancer induction were calculated using models with parameters-sets taken from published data for the general population; dose data were taken from dose volume histograms (DVH).Similar dose distributions in the targets were achieved with all techniques but the absorbed doses in the organs-at-risk varied significantly between the different techniques. The NTCP models based on available data predicted very low probabilities for side-effects in all cases. However, the effective mean doses outside the target volumes, and thus the predicted risk of cancer induction, varied significantly between the techniques. The highest lifetime risk of secondary cancers was estimated for IMXT (30%). The lowest risk was found with IMPT (4%). The risks associated with conventional photon therapy, electron therapy and IMET were 20%, 21% and 15%, respectively.This model study shows that spinal irradiation of young children with photon and electron techniques results in a substantial risk of radiation-induced secondary cancers. Multiple beam IMXT seems to be associated with a particularly high risk of secondary cancer induction. To minimise this risk, IMPT should be the treatment of choice. If proton therapy is not available, advanced electron therapy may provide a better alternative.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- Child
- Dose-Response Relationship
- Radiation
- Electrons
- adverse effects
- therapeutic use
- Female
- Humans
- Male
- Medulloblastoma
- radiotherapy
- Neoplasms
- Radiation-Induced
- etiology
- prevention & control
- Protons
- adverse effects
- therapeutic use
- Radiotherapy
- adverse effects
- methods
- Radiotherapy Dosage
- Risk Assessment
- Spinal Neoplasms
- radiotherapy
- Viscera
- radiation effects
- X-Ray Therapy
- adverse effects
Publication and Content Type
- ref (subject category)
- art (subject category)
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