Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy
| Autor: | Keiichi Nakagawa, Osamu Abe, Hideomi Yamashita, Akihiro Haga, Kae Okuma, Toshikazu Imae, Wataru Takahashi, Kanabu Nawa, Mami Ogita |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Intensity-modulated radiation therapy medicine.medical_treatment R895-920 Tomotherapy Article 030218 nuclear medicine & medical imaging 03 medical and health sciences Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine Tongue Pregnancy medicine Dosimetry Radiology Nuclear Medicine and imaging Radiation treatment planning RC254-282 Tongue cancer business.industry Cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Flattening filter-free 3. Good health Radiation therapy Regimen medicine.anatomical_structure Oncology Fetal dose 030220 oncology & carcinogenesis Gestation Radiology business |
| Zdroj: | Clinical and Translational Radiation Oncology, Vol 20, Iss, Pp 9-12 (2020) Clinical and Translational Radiation Oncology |
| ISSN: | 2405-6308 |
| Popis: | Highlights • An optimal and safe irradiation method for pregnant woman remains controversial. • Flattening-filter free VMAT could reduce the fetal exposure significantly. • As adjuvant CCRT, 66 Gy to the involved nodes was delivered over 33 fractions. • Without any shielding device, the fetal dose of 0.03 Gy in total was estimated. • A vigorous liveborn girl was born vaginally and she had no complications until now. Optimizing irradiation protocols for pregnant women is challenging, because there are few cases and a dearth of fetal dosimetry data. We cared for a 36-year-old pregnant woman with tongue cancer. Prior to treatment, we compared three intensity-modulated radiation therapy (IMRT) techniques, including helical tomotherapy, volumetric arc therapy (VMAT), and flattening-filter free VMAT (FFF-VMAT) using treatment planning software. FFF-VMAT achieved the minimum fetal exposure and was selected as the optimal modality. We prescribed 66 Gy to the involved nodes, 60 Gy to the tumor bed and ipsilateral neck, and 54 Gy to the contralateral neck over 33 fractions. To confirm the out-of-field exposure per fraction, surface doses and the rectal dose were measured during FFF-VMAT delivery. Postoperative chemoradiotherapy was delivered using IMRT and a cisplatin regimen. Without any shielding, the total fetal dose was 0.03 Gy, within the limits established by the ICRP. A healthy girl was born vaginally at 37 weeks’ gestation. |
| Databáze: | OpenAIRE |
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