open access

Vol 24, No 5 (2019)
Original research articles
Published online: 2019-09-01
Submitted: 2018-01-15
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Estimation of radiation-induced second cancer risk associated with the institutional field matching craniospinal irradiation technique: A comparative treatment planning study

Hemalatha Athiyaman, Athiyaman Mayilvaganan, Arun Chougule, Mary Joan, Harvinder Singh Kumar
DOI: 10.1016/j.rpor.2019.06.004
·
Rep Pract Oncol Radiother 2019;24(5):409-420.

open access

Vol 24, No 5 (2019)
Original research articles
Published online: 2019-09-01
Submitted: 2018-01-15

Abstract

Aim

To estimate and compare the lifetime attributable risk (LAR) of radiation-induced second cancer (SC) in pediatric medulloblastoma patients planned with institutional 3D conformal field matching method, gap junction method and Intensity Modulated Radiotherapy (IMRT).

Background

The epidemiological studies on childhood cancer survivors reported that long-term cancer survivors who received radiotherapy are at a significantly increased risk for the development of SC. Hence, the increased concern to predict the SC risk for long-term survivors.

Materials and methods

In addition to institutional field matching planning method, IMRT and gap junction methods were created for ten pediatric medulloblastoma patients. The risk estimates were made based on the site-specific cancer risk coefficient provided by the BEIR VII committee according to the organ equivalent dose for various critical organs. Also, plans were compared for target volume dose distribution and dose received by critical organs.

Results

When compared to the gap junction method, the IMRT and institutional field matching method were superior in normal tissue sparing and dose conformity. However, highly significant volume of low dose associated with IMRT was the main concern for the SC risk. The accumulated LAR for all the critical organs with 3D conformal gap junction and IMRT method was 23–25% while for the 3D conformal field matching method it was 21%.

Conclusion

The LAR associated with the institutional field matching technique was substantially lower. As this method is highly robust and easy to set up, it can be a better choice of a craniospinal irradiation technique where 3DCRT is the only choice of treatment.

Abstract

Aim

To estimate and compare the lifetime attributable risk (LAR) of radiation-induced second cancer (SC) in pediatric medulloblastoma patients planned with institutional 3D conformal field matching method, gap junction method and Intensity Modulated Radiotherapy (IMRT).

Background

The epidemiological studies on childhood cancer survivors reported that long-term cancer survivors who received radiotherapy are at a significantly increased risk for the development of SC. Hence, the increased concern to predict the SC risk for long-term survivors.

Materials and methods

In addition to institutional field matching planning method, IMRT and gap junction methods were created for ten pediatric medulloblastoma patients. The risk estimates were made based on the site-specific cancer risk coefficient provided by the BEIR VII committee according to the organ equivalent dose for various critical organs. Also, plans were compared for target volume dose distribution and dose received by critical organs.

Results

When compared to the gap junction method, the IMRT and institutional field matching method were superior in normal tissue sparing and dose conformity. However, highly significant volume of low dose associated with IMRT was the main concern for the SC risk. The accumulated LAR for all the critical organs with 3D conformal gap junction and IMRT method was 23–25% while for the 3D conformal field matching method it was 21%.

Conclusion

The LAR associated with the institutional field matching technique was substantially lower. As this method is highly robust and easy to set up, it can be a better choice of a craniospinal irradiation technique where 3DCRT is the only choice of treatment.

Get Citation

Keywords

Second cancer; Craniospinal irradiation; Organ equivalent dose; BEIR; Field matching

About this article
Title

Estimation of radiation-induced second cancer risk associated with the institutional field matching craniospinal irradiation technique: A comparative treatment planning study

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 24, No 5 (2019)

Pages

409-420

Published online

2019-09-01

DOI

10.1016/j.rpor.2019.06.004

Bibliographic record

Rep Pract Oncol Radiother 2019;24(5):409-420.

Keywords

Second cancer
Craniospinal irradiation
Organ equivalent dose
BEIR
Field matching

Authors

Hemalatha Athiyaman
Athiyaman Mayilvaganan
Arun Chougule
Mary Joan
Harvinder Singh Kumar

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