Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep-Oct;24(5):409-420.
doi: 10.1016/j.rpor.2019.06.004. Epub 2019 Jul 8.

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

Hemalatha Athiyaman  1 , Athiyaman Mayilvaganan  1 , Arun Chougule  2 , Mary Joan  2 , Harvinder Singh Kumar  3
Affiliations

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

Hemalatha Athiyaman et al. Rep Pract Oncol Radiother. 2019 Sep-Oct.

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.

Keywords: BEIR; Craniospinal irradiation; Field matching; Organ equivalent dose; Second cancer.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Dose distribution for the three planning methods.
Fig. 2
Fig. 2
Mean dose to the organ at risk (OAR).
Fig. 3
Fig. 3
Organ equivalent dose calculated by plateau model for the selected OAR (Method 1 – 3D conformal matched field; Method 2 – IMRT; Method 2 – 3D conformal gap junction).
Fig. 4
Fig. 4
Organ equivalent dose calculated by bell-shaped model for the selected OAR (Method 1 – 3D conformal matched field; Method 2 – IMRT; Method 3 – 3D conformal gap junction).
Fig. 5
Fig. 5
Organ equivalent dose calculated by linear dose response model for the selected OAR (Method 1 – 3D conformal matched field; Method 2 – IMRT; Method 3 – 3D conformal gap junction).
Fig. 6
Fig. 6
The percentage of total lifetime attributable risk of second cancer for the three planning methods by all models.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Nell M.C., Cot T.R., Clegg L., Rorke L.B. Incidence and trends in pediatric malignancies medulloblastoma/primitive neuroectodermal tumor; a SEER update. Med Pediatr Oncol. 2002;39:190–194. - PubMed
    1. Monteith S.J., Heppner P.A., Wood field M.J., Law A.J.J. Pediatric central nervous system tumours in a new Zealand population; a 10 year experience of epidemiology, management and outcomes. J Clin Neurosci. 2006;13:722–729. - PubMed
    1. Suh Y.I., Koo H., Kim T.S. Tumours of the central nervous system in Korea; a multicenter study of 3221 cases. J Neurooncol. 2002;56:251–259. - PubMed
    1. Chan M.Y., Teo W.Y., Soow W.T., Tan A.M. Epidemiology management and treatment outcome of medulloblastoma in Singapore. Ann Acad Med Singapore. 2007;36(5):314–318. - PubMed
    1. Ozek M.M., Cinalli G., Maixner W., Rose C.S. 2000. Posterior fossa tumors in children. New York.