Clinical experience in pediatric neuroblastoma intensity modulated radiotherapy

Abstract

Background: In spite of the numerous publications of dosimetric comparison of intensity modulated radiotherapy (IMRT) versus conventional radiotherapy in pediatrics, few data exist regarding the clinical use of IMRT and its potential late effects.

Procedure: Pediatric neuroblastoma patients treated between November 2008 and October 2010 with IMRT were reviewed. Treatment plans, clinical, laboratory and radiological data at the last follow up date were evaluated.

Results: Thirteen patients received IMRT. The mean age was 4.9 ± 2 years. The radiation dose ranged from 21 to 25.5 Gy with a mean dose of 24.06 Gy. The mean liver dose was 9.81 Gy. The V8 of the liver was 51 ± 20%, and the V15 of the liver was 21 ± 12%. V18 of the right and left kidneys were 32 ± 27% and 23 ± 18% respectively. The minimum and maximum vertebral point doses were 12.82 and 24.87 Gy respectively. The IMRT treatment was well tolerated in terms of acute toxicity. At 26 month follow up, second malignancy and skeletal asymmetry were not noted, and the liver and the kidney functions showed no significant abnormalities.

Conclusions: The use of IMRT in pediatric neuroblastoma confers higher target conformality with better sparing of the kidneys and it did not show any considerable short term side effects.