Higher Energy Megavoltage Photon and Split Beam Technique Minimize the Testicular Dose During Radiation Prophylaxis of Heterotopic Ossification

Mourad, W.F.; Ma, Jinghong; Yang, Cui; He, R.; Ryniak, M.; Shourbaji, R.A.; Mobit, Paul N; Santoro, J.; Nabhani, T.; Katsoulakis, E.; Kabarriti, Rafi; Blakaj, Adriana; Patel, Shyamal; Yan, Wenhui; Blakaj, Dukagjin; Khan, Majid; Packianathan, Satyaseelan; Jennelle, R.; Russell, George V.; Vijayakumar, S.

doi:10.1016/j.ijrobp.2014.05.2009

Cited by 2 publications

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“…Although, a testicular shield is effective in shielding scatter from external (machine head) sources, it does little to prevent in-scatter into the testicular region from within the patient. Hence, in order to further minimize the gonadal dose while maximizing sufficient target volume coverage, we recommend that CTbased simulation, 3-D treatment planning, a SBT and ≥10 MV photon beams be utilized (28,(32)(33)(34).…”

Section: Discussionmentioning

confidence: 99%

Testicular Dose During Prophylaxis of Heterotopic Ossification with Radiation Therapy

Mourad

John

Packianathan

et al. 2017

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Heterotopic ossification (HO) is the pathological process of bone formation in non-osseous tissues following trauma and/or surgical intervention. Following traumatic injury, cellular and hormonal signals from the site of injury, a supply of mesenchymal cells and the appropriate tissue microenvironment are all among the potential factors that could contribute to development of HO in injured tissues (1). Prophylactic radiation therapy (RT) is commonly used to reduce the risk of HO after open reduction and internal fixation (ORIF) of traumatic acetabular fractures (TAFs); heterotopic ossification after operative treatment of the hip using a posterior surgical approach has been reported in up to 50% of such patients (2). Radiation therapy presumably decreases the risk of HO by inhibiting the proliferation of pluripotential mesenchymal cells that could potentially differentiate into osteoblastic stem cells and is usually administered postoperatively, within 72 h of surgery (3-5). However, preoperative RT has also been used in these situations (6)(7)(8). In a recent meta-analysis reporting the incidence of HO after TAF status post ORIF, it was reported that the incidence of HO formation after RT prophylaxis 461 This article is freely accessible online.

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Section: Discussionmentioning

confidence: 99%

Testicular Dose During Prophylaxis of Heterotopic Ossification with Radiation Therapy

Mourad

John

Packianathan

et al. 2017

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“…Ipsilateral (IL) and contralateral (CL) ovaries (OV) were contoured separately and dose volume histograms (DVH) generated. Additional planning trials were created for each patient by utilizing a SBT medially and by using different photon energies (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) to investigate the difference in ovary dose among these maneuvers. Results: The median Mean-dose delivered to ILOV was 59 cGy and the median Max-dose was 177 cGy.…”

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confidence: 99%

“…However, in control patients who received no prophylaxis, it was increased up to 58% (9,10). Using high energy photon beams and split-beam techniques (SBT) radiation to adjacent tissues can be minimized (11)(12)(13)(14)(15). Although the majority of patients at risk of HO are males, females are also susceptible to HO development.…”

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confidence: 99%

Reliable Radiation Technique to Minimize Ovarian Dose During Radiation Prophylaxis of Heterotopic Ossification

Mourad

Packianathan

Yan

et al. 2017

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A biologically significant radiation dose is delivered to the ovaries during HO radiation prophylaxis at the hip joints. Ipsilateral ovarian dose could be reduced by half and contralateral by one-quarter by using CT-based treatment planning with a medial SBT and photon energies above 6 MV. We suggest using no more than 10 MV to minimize neutron contamination. Those techniques should be the standard of care as it provides a reliable method for minimizing the radiation dose to the ovaries, consequently, maximizing female fertility preservation during HO radiation prophylaxis. All female patients in childbearing age should be fully informed about ovarian radiation exposure and possible temporary alteration in ova production and morphology.

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Higher Energy Megavoltage Photon and Split Beam Technique Minimize the Testicular Dose During Radiation Prophylaxis of Heterotopic Ossification

Cited by 2 publications

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Testicular Dose During Prophylaxis of Heterotopic Ossification with Radiation Therapy

Testicular Dose During Prophylaxis of Heterotopic Ossification with Radiation Therapy

Reliable Radiation Technique to Minimize Ovarian Dose During Radiation Prophylaxis of Heterotopic Ossification

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