A method of estimating fetal dose during brain radiation therapy

Mazonakis, Michalis; Damilakis, John; Varveris, H.; Theoharopoulos, Nikos; Gourtsoyiannis, N.

doi:10.1016/s0360-3016(99)00023-1

Cited by 20 publications

(6 citation statements)

References 21 publications

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“…Therefore, some research groups have modified anthropomorphic phantoms mimicking a pregnant belly. [18][19][20] However, using such approaches, it is impractical to model…”

Section: Guidelines Availablementioning

confidence: 99%

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Challenges and opportunities for proton therapy during pregnancy

Blommaert

Saint-Hubert

Depuydt

et al. 2023

Acta Obstet Gynecol Scand

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During pregnancy, the use of radiation therapy for cancer treatment is often considered impossible due to the assumed associated fetal risks. However, suboptimal treatment of pregnant cancer patients and unjustifiable delay in radiation therapy until after delivery can be harmful for both patient and child. In non‐pregnant patients, proton‐radiation therapy is increasingly administered because of its favorable dosimetric properties compared with photon‐radiation therapy. Although data on the use of pencil beam scanning proton‐radiation therapy during pregnancy are scarce, different case reports and dosimetric studies have indicated a more than 10‐fold reduction in fetal radiation exposure compared with photon‐radiation therapy. Nonetheless, the implementation of proton‐radiation therapy during pregnancy requires complex fetal dosimetry for the neutron‐dominated out‐of‐field radiation dose and faces a lack of clinical guidelines. Further exploration and standardization of proton‐radiation therapy during pregnancy will be necessary to improve radiotherapeutic management of pregnant women with cancer and further reduce risks for their offspring.

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“…Therefore, some research groups have modified anthropomorphic phantoms mimicking a pregnant belly. [18][19][20] However, using such approaches, it is impractical to model…”

Section: Guidelines Availablementioning

confidence: 99%

“…While adult female phantoms are commercially available, there are no commercial phantoms modeling pregnant women. Therefore, some research groups have modified anthropomorphic phantoms mimicking a pregnant belly 18–20 . However, using such approaches, it is impractical to model individual patients.…”

Section: Out‐of‐field Dosimetry During Proton‐rtmentioning

confidence: 99%

Challenges and opportunities for proton therapy during pregnancy

Blommaert

Saint-Hubert

Depuydt

et al. 2023

Acta Obstet Gynecol Scand

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“…The use of data from treatment planning systems for out-of-field organ dose calculations is not recommended (25). Different approaches, based either on direct measurements using physical phantoms (26,27) or on Monte Carlo simulations (28), may be applied for assessing the out-of-field organ doses and the relevant probabilities of carcinogenesis. The relatively small sample of patients with low-risk prostate carcinoma should be considered as a limitation of the present study.…”

Section: Mean Parameter Value (±Sd) ---------------------------------mentioning

confidence: 99%

VMAT for prostate cancer with 6‑MV and 10‑MV photons: Impact of beam energy on treatment plan quality and model‑based secondary cancer risk estimates

2021

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The aim of the present study was to examine the effect of the photon beam energy on the volumetric modulated arc therapy (VMAT) plan quality for prostate cancer and on the risk of secondary carcinogenesis. Separate VMAT plans with 6-MV and 10-MV photons were created for 11 low-risk patients with prostate cancer. The prescribed tumor dose was 70 Gy delivered in 28 fractions. The normal tissue integral dose and parameters associated with planning target volume and organs at risk were determined by the treatment planning data. A non-linear mechanistic model considering the effects of tumor dose fractionation and cell proliferation was employed for estimating the patient-specific lifetime attributable risk (LAR) for bladder and rectal cancer induction. Data from differential dose-volume histograms were used for these risk assessments. The mean values of the planning parameters from 6-MV treatment plans differed by 0.2-3.4% from those associated with irradiation using 10-MV photons. The LAR range for developing secondary bladder malignancies varied between 0.041 and 0.129% by the patient under investigation and the beam energy used. The corresponding range for the appearance of rectal malignant diseases was 0.047-0.153%. The mean percentage difference between the bladder cancer risks from VMAT with 6-MV and 10-MV photons was 2.6±2.3%. The corresponding difference for secondary rectal malignancies was 0.7±0.6%. Therefore, VMAT for prostate cancer with both 6-MV and 10-MV photons leads to clinically equivalent treatment plans and to similar secondary bladder and rectal cancer risks.

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“…Toutefois, ces estimations sont fondées sur l'hypothèse que le foetus est représenté par un seul point [28]. Cette hypothèse peut être justifi ée dans les premières semaines postconceptionnelles lorsque la taille de l'embryon est minime, mais l'augmentation de la taille du foetus au cours de la gestation va entraîner des variations considérables de la dose de photons dispersés à travers le foetus [27].…”

Section: Radiothérapieunclassified