A supine cranio-spinal irradiation technique using moving field junctions

• Autorzy: Mani K. R. , Sapru S. , Maria Das K. J. , Basu A.

Identyfikatory

DOI

10.1515/pjmpe-2016-0014

• Języki publikacji: EN

Abstrakty

EN

Aim: To demonstrate a simple technique of cranio-spinal irradiation (CSI) in supine position using inter fraction moving field junctions to feather out any potential hot and cold spots. Materials and Methods: Fifteen patients diagnosed with medulloblastoma were treated during the period February 2011 to June 2015 were included in this study. Out of fifteen patients in the study nine were male and 6 were female with a median age of 13.4 years (range 5-27 years). All the patients were positioned supine on CT simulation, immobilized using thermoplastic mask and aligned using room based laser system. Two parallel opposed lateral fields for the whole brain using an asymmetrical jaw with isocenter at C2 vertebral body. A posterior field also placed to cover the cervical and dorsal field using the same isocenter at C2. The second isocenter was placed at lumbar vertebral region to cover the remaining dorsal, lumbar and sacral region using an inter-fraction moving junction. Field-in-field and enhanced dynamic wedge used to homogeneous dose distribution when required. Results and Discussion: In this study, we found that only two patients failed in the primary site, no radiation myelitis or recurrences in the filed junctions were reported in these fifteen patients with a median follow-up of 36.4 months. The automated sequence of treatment plans with moving junctions in the comfortable supine position negating the need for manual junction matching or junction shifts avoiding potential treatment errors and also facilitating delivery of anesthesia where necessary.

Słowa kluczowe

EN

CSI; medulloblastoma; supine

• Wydawca: Polskie Towarzystwo Fizyki Medycznej
• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2016
• Tom: Vol. 22, Iss. 4
• Strony: 79--83
• Opis fizyczny: Bibliogr. 7 poz., rys., tab.

Twórcy

autor

Mani K. R.

• Research & Development Centre, Bharathiar University, Coimbatore - 641 046, Tamilnadu, India
• Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rai Bareily Road, Lucknow - 226014, Uttar Pradesh, India

autor

Sapru S.

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Gomtinagar, Lucknow, Uttra Pradesh, India

autor

Maria Das K. J.

• Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rai Bareily Road, Lucknow - 226014, Uttar Pradesh, India

autor

Basu A.

• Department of Radiation Oncology, The Mission Hospital, Durgapur - 713212, West Bengal, India

Bibliografia

• [1] Halperin E. Impact of radiation technique upon the outcome of treatment for medulloblastoma. Int J Radiat Oncol Biol Phys. 1196;36(1):233-239.
• [2] Parker WA, Freeman CR. A simple technique for cranio-spinal radiotherapy in the supine position. Radiother Oncol. 2006;78(2):217-222.
• [3] Peñagarícano J, Moros E, Corry P, et al. Pediatric craniospinal axis irradiation with helical tomotherapy: patient outcome and lack of acute pulmonary toxicity. Int J Radiat Oncol Biol Phys. 2009;75(4):1155-1161.
• [4] Skowrońska-Gardas A, Chojnacka M, Morawska-Kaczyńska M, et al. Patterns of failure in children with medulloblastoma treated with 3D conformal radiotherapy. Radiother Oncol. 2007;84(1):26-33.
• [5] Taylor RE. United Kingdom Children’s Cancer Study Group (UKCCSG) Radiotherapy and Brain Tumour Groups: Medulloblastoma/PNET and Craniospinal Radiotherapy (CSRT): Report of a Workshop held in Leeds, 30 June 1999. Clin Oncol. 2001;13(1):58-64.
• [6] Yom SS. Frija EK, Mahajan A, et al. Field-In-Field Technique With Intrafractionally Modulated Junction Shifts for Craniospinal Irradiation. Int J Radiat Oncol Biol Phys. 2007;69(4);1193-1198.
• [7] South M, Chiu JK, The BS, et al. Supine Craniospinal Irradiation Using Intrafractional Junction Shifts and Field-in-Field Dose Shaping: Early Experience at Methodist Hospital. Int J Radiat Oncol Biol Phys. 2008;71(2):477-483.