Comparison of Helical Tomotherapy versus Conventional Radiation to Deliver Craniospinal Radiation
| Autor: | Timothy J. Kinsella, Bruce Latimer, Ravi Kulasekere, Donald Dobbins, Charles A. Kunos |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Cancer Research Adolescent medicine.medical_treatment Blood count Lumbar vertebrae Radiation Tomotherapy medicine Humans Cerebellar Neoplasms Child business.industry Radiotherapy Planning Computer-Assisted Synostosis medicine.disease Spine Vertebra Vertebral body medicine.anatomical_structure Spinal Cord Oncology Female Cranial Irradiation Tomography X-Ray Computed Nuclear medicine business Tomography Spiral Computed Craniospinal Medulloblastoma |
| Zdroj: | Technology in Cancer Research & Treatment. 7:227-233 |
| ISSN: | 1533-0338 1533-0346 |
| DOI: | 10.1177/153303460800700308 |
| Popis: | The purpose of this study was to investigate whether helical tomotherapy would better dose-limit growing vertebral ring apophyses during craniospinal radiation as compared to conventional techniques. Four pediatric patients with M0 medulloblastoma received tomotherapy craniospinal radiation (23.4 Gy, 1.8 Gy/fx) by continuous helical delivery of 6 MV photons. Weekly blood counts were monitored. For comparison, conventional craniospinal radiation plans were generated. To assist in tomotherapy planning, a cross-sectional growth study of 52 children and young adults was completed to evaluate spine growth and maturation. Vertebral ring apophyses first fused along the posterolateral body-pedicle synostosis, proceeding circumferentially toward the anterior vertebral body such that the cervical and lumbar vertebrae fused early and mid-thoracic vertebrae fused late. For the four pediatric patients, tomotherapy resulted between 2% and 14% vertebral volume exceeding 23 Gy. Conventional craniospinal radiation predicted between 33% and 44% exceeding 23 Gy. Cumulative body radiation doses exceeding 4 Gy were between 50% and 57% for tomotherapy and between 25% and 37% for conventional craniospinal radiation. Tomotherapy radiation reduced neutrophil, platelet, and erythrocyte hemoglobin levels during treatment. Tomotherapy provides improved dose avoidance to growing vertebrae as compared to conventional craniospinal radiation. However, the long-term effects of tomotherapy dose avoidance on spine growth and large volume low dose radiation in children are not yet known. |
| Databáze: | OpenAIRE |
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