Intensity modulated radiotherapy (IMRT) in bilateral retinoblastoma

Atalar, Banu; Özyar, Enis; Günduz, Kaan; Güngör, Görkem

doi:10.2478/v10019-010-0013-0

Cited by 6 publications

(5 citation statements)

References 17 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…GKRS was proposed as an alternative to enucleation. Several publications have reported the successful use of proton beam radiotherapy, stereotactic radiotherapy, and intensity-modulated radiotherapy in children with Rb [12][13][14][15][16][17][18][19]. However, these methods are associated with the need for multiple (up to 30) sessions in children under general anesthesia, the difficulty of immobilizing the eye at each session, and the cost of treatment (concerning proton beam therapy).…”

Section: Discussionmentioning

confidence: 99%

“…To reduce such complications, treatment modalities have shifted towards new radiation therapy techniques with the possibility of creating a small high-precision radiation field sparing surrounding healthy tissues. These modalities include intensity-modulated radiotherapy, stereotactic conformal radiotherapy, and proton beam radiation therapy [12][13][14][15][16][17][18][19]. To the best of our knowledge, no information on single fraction Gamma Knife® radiosurgery (GKRS) for intraocular Rb exists.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stereotactic Gamma Knife® Radiosurgery of Intraocular Retinoblastoma: Six-Year Experience

Yarovoy¹,

Golanov²,

Yarovaya³

et al. 2022

Cureus

View full text Add to dashboard Cite

BackgroundExternal beam radiotherapy for resistant retinoblastoma is now seen as a last resort to saving the eye because of the risk of severe side effects: secondary cancers and cosmetic problems of orbital bone growth retardation. To reduce such complications, treatment modalities have shifted towards new radiation therapy techniques. No information on single fraction Gamma Knife® radiosurgery (GKRS) for intraocular retinoblastoma exists. Materials and methodsEighteen children (19 eyes) with retinoblastoma were treated with GKRS. The mean age at the time of treatment was 35 months (from 12 to 114 months). Before GKRS, all routes of chemotherapy delivery were held in all cases. The eligibility criteria for GKRS were retinoblastomas not amenable either to systemic or local chemotherapy and local ophthalmological treatment, retinoblastomas too large for conventional local methods, and inability to perform intraarterial chemotherapy. Conventional external beam radiotherapy was excluded in the presented cases, given the possible complications mentioned above. In every case, eye removal was suggested to the child's parents, but they flatly refused. GKRS was proposed as the last chance to save the eye (in four cases, it was performed on the only eye). The median prescribed dose was 22 Gy (interquartile range [IQR]: 18-35 Gy), and the median prescribed isodose was 50% (IQR: 36-90%). ResultsLocal control was achieved in 79% of cases (complete tumor regression in 69%, incomplete regression in 10%). Two eyes (10.5%) could not be preserved and had to be enucleated due to the tumor recurrence. Two eyes (10.5%) developed secondary complications (total vitreous hemorrhage, retinal detachment, and iris neovascularization), making adequate tumor control nearly impossible. Overall, 15 eyes (79%) were preserved, and four eyes (21%) were enucleated after GKRS with no signs of tumor recurrence and metastasis in the mean follow-up of 41 months. No acute radiation side effects occurred in any patient after GKRS. Ten children (10 eyes, 53%) were diagnosed with vitreous hemorrhage from mild to severe. Three eyes presented with optic neuropathy one year after GKRS, and four eyes developed retinopathy. Radiation-induced cataract occurred in two eyes. There were no cases of secondary glaucoma or keratopathy in our study. All patients and eyes treated by GKRS were stable within 41 months (from seven to 74 months). ConclusionsSingle fraction Gamma Knife® radiosurgery may be a reasonable salvage treatment for resistant and recurrent retinoblastoma as an alternative approach to enucleation in selected cases. GKRS should be considered in retinoblastoma management.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stereotactic Gamma Knife® Radiosurgery of Intraocular Retinoblastoma: Six-Year Experience

Yarovoy¹,

Golanov²,

Yarovaya³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…2,3 Importantly, some of these techniques are even capable of achieving results comparable to those traditionally obtained only through surgery. [4][5][6] As a result, it is essential that we encourage young radiation oncologists to constantly make efforts to develop their knowledge and skills in the three fundamental areas of the field: basic research, clinical knowledge, and technical understanding.…”

Section: Introductionmentioning

confidence: 99%

The next generation of radiation oncologists: Challenges and perspectives

Navarro

Cacicedo

2012

Reports of Practical Oncology & Radiotherapy

View full text Add to dashboard Cite

“…Intensity-modulated radiation therapy (IMRT) involves complex treatment plans that are completely patient specific in order to highly conform delivered dose to the treatment volume, thus improving normal tissue sparing as compared to more traditional radiotherapy techniques. 1 , 2 As a consequence, the complexity and uniqueness of these treatment plans demand patient-specific pretreatment quality assurance (QA) of all IMRT treatments. Standard methods of IMRT QA involve ionization chambers, diode arrays and radiographic films, often used in some combination to provide verification of absolute dose, field geometry, number of monitor units, etc.…”

Section: Introductionmentioning

confidence: 99%

A fully electronic intensity-modulated radiation therapy quality assurance (IMRT QA) process implemented in a network comprised of independent treatment planning, record and verify, and delivery systems

Bailey

Kumaraswamy²,

Podgorsak

2010

Radiology and Oncology

View full text Add to dashboard Cite

BackgroundThe purpose of this study is to implement an electronic method to perform and analyze intensity-modulated radiation therapy quality assurance (IMRT QA) using an aSi megavoltage electronic portal imaging device in a network comprised of independent treatment planning, record and verify (R&V), and delivery systems.MethodsA verification plan was generated in the treatment planning system using the actual treatment plan of a patient. After exporting the treatment fields to the R&V system, the fields were delivered in QA mode with the aSi imager deployed. The resulting dosimetric images are automatically stored in a DICOM-RT format in the delivery system treatment console computer. The relative dose density images are subsequently pushed to the R&V system. The absolute dose images are then transferred electronically from the treatment console computer to the treatment planning system and imported into the verification plan in the dosimetry work space for further analysis. Screen shots of the gamma evaluation and isodose comparison are imported into the R&V system as an electronic file (e.g. PDF) to be reviewed prior to initiation of patient treatment. A relative dose image predicted by the treatment planning system can also be sent to the R&V system to be compared with the relative dose density image measured with the aSi imager.ResultsOur department does not have integrated planning, R&V, and delivery systems. In spite of this, we are able to fully implement a paperless and filmless IMRT QA process, allowing subsequent analysis and approval to be more efficient, while the QA document is directly attached to its specific patient chart in the R&V system in electronic form. The calculated and measured relative dose images can be compared electronically within the R&V system to analyze the density differences and ensure proper dose delivery to patients.ConclusionsIn the absence of an integrated planning, verifying, and delivery system, we have shown that it is nevertheless possible to develop a completely electronic IMRT QA process.

show abstract

Intensity modulated radiotherapy (IMRT) in bilateral retinoblastoma

Cited by 6 publications

References 17 publications

Stereotactic Gamma Knife® Radiosurgery of Intraocular Retinoblastoma: Six-Year Experience

Stereotactic Gamma Knife® Radiosurgery of Intraocular Retinoblastoma: Six-Year Experience

The next generation of radiation oncologists: Challenges and perspectives

A fully electronic intensity-modulated radiation therapy quality assurance (IMRT QA) process implemented in a network comprised of independent treatment planning, record and verify, and delivery systems

Contact Info

Product

Resources

About