A review on fetal dose in Radiotherapy: A historical to contemporary perspective

Wong, Yun Ming; Koh, Calvin Wei Yang; Lew, Kah Seng; Chua, Clifford Ghee Ann; Nei, Wen Long; Tan, Hong Qi; Lee, James Cheow Lei; Mazonakis, Michalis; Damilakis, John

doi:10.1016/j.ejmp.2022.102513

Cited by 9 publications

(18 citation statements)

References 149 publications

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“…T A B L E 5 Energy dispersive x-ray analysis results of the upper extremities of the control and experimental groups. death can be seen (Wong et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

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The effect of ionizing radiation on the fetal bone development in pregnant rats: Role of melatonin

Tokpinar,

Nisari,

Yilmaz

et al. 2023

Microscopy Res & Technique

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Radiation has been widely used in many business sectors over the last century. Our study investigated the possible teratogenic effects of radiation on the bones of rat fetuses and the protective effect of melatonin against these effects. In this study, 15 pregnant female Wistar albino rats were used. These rats were divided into four groups: the control group, melatonin group (10 mg/kg/day), radiation group (0.5 gray), radiation (0.5 gray) + melatonin group (10 mg/kg/day), and sham group (1 mm hanks/day). The skeletal system development of fetuses was examined with double skeletal and scanning electron microscope (SEM), histopathological methods. In our study, fetal weight, placental weight, and fetal morphometric values were found to be statistically significantly decreased in the radiation group compared to the control group (p < .05). In immünohistochemistry (IHC) analysis, alkaline phosphatase, and tartrate‐resistant acid phosphatase) concentrations were found to be significantly lower in the radiation group compared to the other groups. In the SEM analysis, it was observed that the amount of calcium and sodium decreased when the radiation group was compared with the other groups. As a result, when exposed to ionizing radiation during pregnancy, melatonin has a protective feature against the negative effects of radiation on the bone development of fetuses.Research Highlights In our study, fetuses obtained from pregnant rats exposed to ionizing radiation were examined. In this study, the effect of melatonin on bone development in fetuses exposed to gray ionizing radiation was investigated. There are few studies on our subject in the literature. We believe that our findings will contribute to other planned studies.

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“…T A B L E 5 Energy dispersive x-ray analysis results of the upper extremities of the control and experimental groups. death can be seen (Wong et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

“…Since fetal cells are cells in this group, they are very affected by radiation. If radiation exposure occurs during gestation, fetal growth retardation, small head sizes, mental retardation, cancer development, and death can be seen (Wong et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

The effect of ionizing radiation on the fetal bone development in pregnant rats: Role of melatonin

Tokpinar,

Nisari,

Yilmaz

et al. 2023

Microscopy Res & Technique

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“…Unwanted secondary effects in patients undergoing external radiotherapy are often linked to out-of-field doses. The contribution of scattered neutrons is important to quantify especially for cases of pediatric patients (Peters et al 2010, Mukherjee et al 2017, individuals with electronic devices such as pacemakers (Konefał et al 2020, Koivunoro et al 2011, those with metallic implants (Oancea et al 2018), and pregnant women (de Saint-Hubert et al 2021, Wong et al 2023). In the case of external radiotherapy, the out-of-field equivalent dose from neutrons presents a significant issue for the aforementioned groups.…”

Section: Introduction and Goalsmentioning

confidence: 99%

“…Kids and pregnant women may experience various effects, depending on the dose received, tumor location, and fetal age. However, research in this particular area remains limited and it is currently under investigation by various groups (Cravo Sá et al 2020, de Saint-Hubert et al 2021, Knežević et al 2022, Wong et al 2023.…”

Section: Introduction and Goalsmentioning

confidence: 99%

Thermal neutron detection and track recognition method in reference and out-of-field radiotherapy FLASH electron fields using Timepix3 detectors

Oancea,

Solc,

Bourgouin

et al. 2023

Phys. Med. Biol.

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Objective. This work presents a method for enhanced detection, imaging, and measurement of the thermal neutron flux. Approach. Measurements were performed in a water tank, while the detector is positioned out-of-field of a 20 MeV ultra-high pulse dose rate electron beam. A semiconductor pixel detector Timepix3 with a silicon sensor partially covered by a 6LiF neutron converter was used to measure the flux, spatial, and time characteristics of the neutron field. To provide absolute measurements of thermal neutron flux, the detection efficiency calibration of the detectors was performed in a reference thermal neutron field. Neutron signals are recognized and discriminated against other particles such as gamma rays and x-rays. This is achieved by the resolving power of the pixel detector using machine learning algorithms and high-resolution pattern recognition analysis of the high-energy tracks created by thermal neutron interactions in the converter. Main results. The resulting thermal neutrons equivalent dose was obtained using conversion factor (2.13(10) pSv·cm2) from thermal neutron fluence to thermal neutron equivalent dose obtained by Monte Carlo simulations. The calibrated detectors were used to characterize scattered radiation created by electron beams. The results at 12.0 cm depth in the beam axis inside of the water for a delivered dose per pulse of 1.85 Gy (pulse length of 2.4 μs) at the reference depth, showed a contribution of flux of 4.07(8) × 103 particles·cm−2·s−1 and equivalent dose of 1.73(3) nSv per pulse, which is lower by ∼9 orders of magnitude than the delivered dose. Significance. The presented methodology for in-water measurements and identification of characteristic thermal neutrons tracks serves for the selective quantification of equivalent dose made by thermal neutrons in out-of-field particle therapy.

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“…Indeed, the safety of RT during pregnancy is probably the least investigated, with most data on fetal safety being derived from small cohorts as well as pregnant survivors of atomic bombs and nuclear accidents. 2,3 Following current consensus, RT can be administered during pregnancy when the fetal radiation exposure is kept below 100 mSv, which is being considered a safe threshold for deterministic effects during all stages of pregnancy. [2][3][4] On the other hand, the probability of stochastic effects, such as cancer and genetic effects, is considered linearly proportional to the fetal radiation dose without a…”

mentioning

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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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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A review on fetal dose in Radiotherapy: A historical to contemporary perspective

Cited by 9 publications

References 149 publications

The effect of ionizing radiation on the fetal bone development in pregnant rats: Role of melatonin

The effect of ionizing radiation on the fetal bone development in pregnant rats: Role of melatonin

Thermal neutron detection and track recognition method in reference and out-of-field radiotherapy FLASH electron fields using Timepix3 detectors

Challenges and opportunities for proton therapy during pregnancy

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