Out-of-field organ doses and associated radiogenic risks from para-aortic radiotherapy for testicular seminoma

Mazonakis, Michalis; Berris, Theocharis; Varveris, C.; Lyraraki, Efrossyni; Damilakis, John

doi:10.1118/1.4870376

Cited by 9 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In photon radiotherapy, out-of-field doses are mainly caused by radiation scattered in the collimators, radiation leakage from the linear accelerator head, and radiation scattered inside the patient's body (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Out-of-field doses are non-target doses that are outside of the planning target volume (PTV) and also outside the primary field edge (4).…”

Section: Introductionmentioning

confidence: 99%

Comparison of 3DCRT and IMRT out-of-field doses in pediatric patients using Monte Carlo simulations with treatment planning system calculations and measurements

et al. 2022

View full text Add to dashboard Cite

3DCRT and IMRT out-of-field doses in pediatric patients were compared using Monte Carlo simulations with treatment planning system calculations and measurements.PurposeOut-of-field doses are given to healthy tissues, which may allow the development of second tumors. The use of IMRT in pediatric patients has been discussed, as it leads to a “bath” of low doses to large volumes of out-of-field organs and tissues. This study aims to compare out-of-field doses in pediatric patients comparing IMRT and 3DCRT techniques using measurements, Monte Carlo (MC) simulations, and treatment planning system (TPS) calculations.Materials and methodsA total dose of 54 Gy was prescribed to a PTV in the brain of a pediatric anthropomorphic phantom, for both techniques. To assess the out-of-field organ doses for both techniques, two treatment plans were performed with the 3DCRT and IMRT techniques in TPS. Measurements were carried out in a LINAC using a pediatric anthropomorphic phantom and thermoluminescent dosimeters to recreate the treatment plans, previously performed in the TPS. A computational model of a LINAC, the associated multileaf collimators, and a voxelized pediatric phantom implemented in the Monte Carlo N-Particle 6.1 computer program were also used to perform MC simulations of the out-of-field organ doses, for both techniques.ResultsThe results obtained by measurements and MC simulations indicate a significant increase in dose using the IMRT technique when compared to the 3DCRT technique. More specifically, measurements show higher doses with IMRT, namely, in right eye (13,041 vs. 593 mGy), left eye (6,525 vs. 475 mGy), thyroid (79 vs. 70 mGy), right lung (37 vs. 28 mGy), left lung (27 vs. 20 mGy), and heart (31 vs. 25 mGy). The obtained results indicate that out-of-field doses can be seriously underestimated by TPS.DiscussionThis study presents, for the first time, out-of-field dose measurements in a realistic scenario and calculations for IMRT, centered on a voxelized pediatric phantom and an MC model of a medical LINAC, including MLC with log file-based simulations. The results pinpoint significant discrepancies in out-of-field doses for the two techniques and are a cause of concern because TPS calculations cannot accurately predict such doses. The obtained doses may presumably increase the risk of development of second tumors.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparison of 3DCRT and IMRT out-of-field doses in pediatric patients using Monte Carlo simulations with treatment planning system calculations and measurements

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Similarly, Stephanie A et al [19] reviewed that the risk of secondary malignant neoplasms after radiotherapy was significantly higher than those who did not, and the risk was dose related. In another study conduct by Mazonakis et al [20], Para-aortic radiotherapy in a low dose of 20Gy may lead to a very small probability for the appearance of prostate, lung, or thyroid cancer, however, para-aortic radiotherapy may result in a substantial increase of the baseline risk for the induction of bladder or esophageal cancer.…”

Section: Discussionmentioning

confidence: 95%

Evaluating the Effect of Post-Operative Radiotherapy on Long Term Survival of Testicular Seminomas: A Population Based Study

X¹,

Q²,

M³

et al. 2021

austinjradiatoncolcancer

View full text Add to dashboard Cite

Objectives: To assess the effect of post-operative radiotherapy (PORT) on long term survival in Testicular Seminoma (TS) patients and factors may effect the prognosis of PORT patients. Results: 12957 patients with a median age of 36.00 (13.00-107.00) years were pathologically diagnosed as primary TS. PORT was performed in 3407 patients. Patients with clinical stages I, II, and III testicular cancer accounted for 70.69% (n=9159), 8.30% (n=1075), and 5.72% (n=741) of all patients, respectively. According to results of multivariate Cox proportional hazard model, lower risk of cancer specific mortality was related with PORT in all patients (HR=0.40 95% CI=0.25-0.63 p<0.0001). However, no benefit in survival (p>0.05) was brought by PORT in either clinical stage. Aging, elevated human chorionic gonadotropin and lactate dehydrogenase level were related with higher risk of cancer specific mortality in PORT patients (p>0.05). Furthermore, aging and elevated LDH were inversely related with the prognosis of CSI PORT patients. No significant risk factor was observed in CSII and III PORT patients. Conclusion: PORT can be benefit to the long term survival in TS patients, however, it did not show significant advantage in patients of either clinical stage based on the results of our study. Elevation of human chorionic gonadotropin and lactate dehydrogenase levels and elder age related with higher risk of CSM in PORT patients. Utilization of PORT in the management of TS should be considered comprehensively.

show abstract

“…Furthermore, the software cannot be used for cancer risk assessment to distant sites from the treatment volume exposed to low doses due to secondary radiation. Different computational or measurement methods should be used for estimating the out-of-field organ doses and radiogenic risks [24,25]. conclusion SCRcalc is a newly developed software tool for the automatic estimation of the patient-and organ-specific cancer risk due to radiotherapy.…”

Section: Resultsmentioning

confidence: 99%

A software tool for organ-specific second cancer risk assessment from exposure to therapeutic doses

Tzanis

Mazonakis

Damilakis

2022

Rep Pract Oncol Radiother.

Self Cite

View full text Add to dashboard Cite

show abstract

Out-of-field organ doses and associated radiogenic risks from para-aortic radiotherapy for testicular seminoma

Cited by 9 publications

References 24 publications

Comparison of 3DCRT and IMRT out-of-field doses in pediatric patients using Monte Carlo simulations with treatment planning system calculations and measurements

Comparison of 3DCRT and IMRT out-of-field doses in pediatric patients using Monte Carlo simulations with treatment planning system calculations and measurements

Evaluating the Effect of Post-Operative Radiotherapy on Long Term Survival of Testicular Seminomas: A Population Based Study

A software tool for organ-specific second cancer risk assessment from exposure to therapeutic doses

Contact Info

Product

Resources

About