Optimization of Craniospinal Irradiation for Pediatric Medulloblastoma Using VMAT and IMRT

Al‐Wassia, Rolina; Ghassal, Noor M.; Naga, A.; Awad, N.; Bahadur, Yasir A.; Constantinescu, C.

doi:10.1097/mph.0000000000000418

Cited by 21 publications

(8 citation statements)

References 46 publications

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“…Our dosimetric results were comparable to several dosimetric studies that have investigated highly conformal radiotherapy techniques such as IMRT, HT, or VMAT for CSI planning, most of which found that the use of VMAT, compared to conventional CSI, significantly reduces OAR doses while preserving good target coverage. With a 36 Gy dose and RapidArc technology, Fogliata et al.…”

Section: Discussionsupporting

confidence: 79%

“…In comparing VMAT to IMRT, Al‐Wassia et al. found that compared to IMRT, VMAT had superior dose reduction to the eyes, lens and optic nerve, cochlea, heart, thyroid, brain, testes, uterus, breasts, and kidneys . By minimizing the dose to these OARs, VMAT would be able to theoretically minimize dose‐related long‐term complications such as neurocognitive decline, hearing and vision deficits, and endocrine dysfunction.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute toxicity of craniospinal irradiation with volumetric‐modulated arc therapy in children with solid tumors

Wong

Ragab

Tran

et al. 2018

Pediatric Blood & Cancer

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Acute toxicity of craniospinal irradiation with volumetric‐modulated arc therapy in children with solid tumors

Wong

Ragab

Tran

et al. 2018

Pediatric Blood & Cancer

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“…They were able to improve the coverage of the target area by using the VMAT technique, however, this did not result in significant differences. No remarkable differences were seen in terms of the dose exposures of the organs-at-risk between the two techniques 15 . These results were supported by other studies conducted at other institutes 16 − 18 .…”

Section: Sebestyén Et Al Demonstrated the Technique Utilized At Theimentioning

confidence: 82%

Assessment of the results and the haematologic side effects of the 3D conformal and the IMRT/ARC therapies delivered during the craniospinal irradiation of childhood tumors, in a follow-up period of 5 years

Lőcsei

Farkas

et al. 2020

Preprint

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Objectives The craniospinal irradiation (CSI) of childhood tumors with Rapidarc technique is a new way of treatment. Our objective was to compare the acute haematologic toxicity pattern during 3D conformal radiotherapy with the application of the novel techniques. Materials and methods Data from patients treated between 2007 and 2014 has been collected and seven patients were identified in each of both treatment groups. The acute blood toxicity results were obtained, after establishing a general linear model, by using the SPSS software. Furthermore, the dose exposure of the organs-at-risk has been compared. Patients have been followed-up for a minimum of five years, then progression-free survival and overall survival data were assessed. Results After the assessment of the laboratory parameters of the two groups, it may be concluded that no significant differences were detected in terms of the mean dose exposures of the normal tissues or the acute hematological side-effects during the IMRT/ARC and the 3D conformal treatment. Laboratory parameters significantly decreased compared to the baseline values during the treatment weeks. Nevertheless, no significant differences were detected between the two groups. No remarkable differences were confirmed between the two groups regarding the five-year progression-free survival and overall survival, and no signs of serious irradiation organ toxicity were observed during the follow-up period in either of the groups. Conclusion Rapidarc technique can be used safely even for the treatment of childhood tumors, as the extent of normal tissue dose exposures and that of acute hematological side effects is not higher.

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“…A new treatment strategy emerged with the introduction of the helical Tomotherapy (Accuray Inc, Sunnyvale, CA, USA) where large target volumes can be irradiated continuously and homogenously without field matching [ 13 , 18 , 20 , 27 , 28 , 29 ]. Additionally, HT is executed in supine position, which is favorable for nontarget tissue sparing, patient comfort, and dose conformity [ 30 , 31 , 32 ] with a homogenous dose distribution compared to 3DCRT [ 13 , 18 , 21 , 27 , 29 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Toxicity Reduction after Craniospinal Irradiation via Helical Tomotherapy in Patients with Medulloblastoma: A Unicentric Retrospective Analysis

Öztunali

Elsayad

Scobioala

et al. 2021

Cancers

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Objectives: Recent trials with craniospinal irradiation (CSI) via helical Tomotherapy (HT) demonstrated encouraging medulloblastoma results. In this study, we assess the toxicity profile of different radiation techniques and estimate survival rates. Materials and Methods: We reviewed the records of 46 patients who underwent irradiation for medulloblastoma between 1999 and 2019 (27 conventional radiotherapy technique (CRT) and 19 HT). Patient, tumor, and treatment characteristics, as well as treatment outcomes—local control rate (LCR), event-free survival (EFS), and overall survival (OS)—were reviewed. Acute and late adverse events (AEs) were evaluated according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria. Results: In total, 43 courses of CSI and three local RT were administered to the 46 patients: 30 were male, the median age was 7 years (range 1–56). A median total RT dose of 55 Gy (range 44–68) and a median CSI dose of 35 Gy (range, 23.4–40) was delivered. During follow-up (median, 99 months), six patients (13%) developed recurrence. The EFS rate after 5 years was 84%. The overall OS rates after 5 and 10 years were 95% and 88%, respectively. There were no treatment-related deaths. Following HT, a trend towards lower grade 2/3 acute upper gastrointestinal (p = 0.07) and subacute CNS (p = 0.05) toxicity rates was detected compared to CRT-group. The risk of late CNS toxicities, mainly grade 2/3, was significantly lower following HT technique (p = 0.003). Conclusion: CSI via HT is an efficacious treatment modality in medulloblastoma patients. In all, we detected a reduced rate of several acute, subacute, and chronic toxicities following HT compared to CRT.

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Optimization of Craniospinal Irradiation for Pediatric Medulloblastoma Using VMAT and IMRT

Cited by 21 publications

References 46 publications

Acute toxicity of craniospinal irradiation with volumetric‐modulated arc therapy in children with solid tumors

Acute toxicity of craniospinal irradiation with volumetric‐modulated arc therapy in children with solid tumors

Assessment of the results and the haematologic side effects of the 3D conformal and the IMRT/ARC therapies delivered during the craniospinal irradiation of childhood tumors, in a follow-up period of 5 years

Toxicity Reduction after Craniospinal Irradiation via Helical Tomotherapy in Patients with Medulloblastoma: A Unicentric Retrospective Analysis

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