Acute toxicities after volumetric modulated arc therapy for craniospinal irradiation in adults

Autor: Timothy Wagner, Mark D. Bonnen, Pamela Myers, Michelle Ludwig, Julianna K. Bronk, Jason Bryan, Danny Tran
Rok vydání: 2018
Předmět:
Zdroj: Journal of Radiation Oncology. 7:317-323
ISSN: 1948-7908
1948-7894
DOI: 10.1007/s13566-018-0362-7
Popis: Different methodologies to deliver craniospinal irradiation (CSI) to patients have been implemented due to the toxicity and planning challenges associated with traditional three-dimensional conformal radiation therapy. Patient outcomes data are needed to assess the feasibility and safety of these methods. We describe the set up and planning methodology used in our clinic to treat adult patients undergoing CSI using volumetric-modulated arc therapy (VMAT). Eight patients treated with CSI using VMAT delivery were reviewed for treatment-associated toxicities and survival. Median follow-up time was 7.5 months (range 1–44 months), and median radiation dose was 36 Gy (range 23.4–36 Gy). The most common acute toxicities experienced were nausea (n = 5, 62.5%), fatigue (n = 4, 50%), and sore throat (n = 3, 37.5%). Grade III toxicities included leukopenia (n = 2, 25%), fatigue (n = 1, 12.5%), anemia (n = 1, 12.5%), and nausea (n = 1, 12.5%). There were no grade IV or V toxicities. Only patients receiving adjuvant chemotherapy (n = 2) had hematologic toxicities (grade II anemia, n = 1; grade III anemia n = 1; grade III leukopenia, n = 2). VMAT radiation delivery is feasible and well tolerated in adult patients receiving CSI. The addition of adjuvant chemotherapy carries an increased risk for hematologic toxicity.
Databáze: OpenAIRE
Externí odkaz: