open access

Vol 15, No 1 (2010)
Published online: 2010-01-01
Submitted:
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Craniospinal radiotherapy in children: Electron- or photon-based technique of spinal irradiation

Marzanna Chojnacka, Anna Skowrońska-Gardas, Marzena Morawska-Kaczyńska, Anna Zygmuntowicz-Piętka, Katarzyna Pędziwiatr, Anna Semaniak
DOI: 10.1016/j.rpor.2010.01.005
·
Rep Pract Oncol Radiother 2010;15(1):21-24.

open access

Vol 15, No 1 (2010)
Published online: 2010-01-01
Submitted:

Abstract

Background

The prone position and electron-based technique for craniospinal irradiation (CSI) have been standard in our department for many years. But this immobilization is difficult for the anaesthesiologist to gain airway access. The increasing number of children treated under anaesthesia led us to reconsider our technique.

Aim

The purpose of this study is to report our new photon-based technique for CSI which could be applied in both the supine and the prone position and to compare this technique with our electron-based technique.

Materials and methods

Between November 2007 and May 2008, 11 children with brain tumours were treated in the prone position with CSI. For 9 patients two treatment plans were created: the first one using photons and the second one using electron beams for spinal irradiation. We prepared seven 3D-conformal photon plans and four forward planned segmented field plans. We compared 20 treatment plans in terms of target dose homogeneity and sparing of organs at risk.

Results

In segmented field plans better dose homogeneity in the thecal sac volume was achieved than in electron-based plans. Regarding doses in organs at risk, in photon-based plans we obtained a lower dose in the thyroid but a higher one in the heart and liver.

Conclusions

Our technique can be applied in both the supine and prone position and it seems to be more feasible and precise than the electron technique. However, more homogeneous target coverage and higher precision of dose delivery for photons are obtained at the cost of slightly higher doses to the heart and liver.

Abstract

Background

The prone position and electron-based technique for craniospinal irradiation (CSI) have been standard in our department for many years. But this immobilization is difficult for the anaesthesiologist to gain airway access. The increasing number of children treated under anaesthesia led us to reconsider our technique.

Aim

The purpose of this study is to report our new photon-based technique for CSI which could be applied in both the supine and the prone position and to compare this technique with our electron-based technique.

Materials and methods

Between November 2007 and May 2008, 11 children with brain tumours were treated in the prone position with CSI. For 9 patients two treatment plans were created: the first one using photons and the second one using electron beams for spinal irradiation. We prepared seven 3D-conformal photon plans and four forward planned segmented field plans. We compared 20 treatment plans in terms of target dose homogeneity and sparing of organs at risk.

Results

In segmented field plans better dose homogeneity in the thecal sac volume was achieved than in electron-based plans. Regarding doses in organs at risk, in photon-based plans we obtained a lower dose in the thyroid but a higher one in the heart and liver.

Conclusions

Our technique can be applied in both the supine and prone position and it seems to be more feasible and precise than the electron technique. However, more homogeneous target coverage and higher precision of dose delivery for photons are obtained at the cost of slightly higher doses to the heart and liver.

Get Citation

Keywords

Craniospinal irradiation; Supine position; Late toxicity

About this article
Title

Craniospinal radiotherapy in children: Electron- or photon-based technique of spinal irradiation

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 15, No 1 (2010)

Pages

21-24

Published online

2010-01-01

DOI

10.1016/j.rpor.2010.01.005

Bibliographic record

Rep Pract Oncol Radiother 2010;15(1):21-24.

Keywords

Craniospinal irradiation
Supine position
Late toxicity

Authors

Marzanna Chojnacka
Anna Skowrońska-Gardas
Marzena Morawska-Kaczyńska
Anna Zygmuntowicz-Piętka
Katarzyna Pędziwiatr
Anna Semaniak

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