Dosimetric Analysis of Clinical Case of Radiation Therapy of Metastases in the Head Skin
https://doi.org/10.37174/2587-7593-2018-1-4-5-13
Abstract
Purpose: Analyze the technique of irradiation of metastases in the scalp on the example of a clinical case from the point of view of dose distribution and tissue tolerance to radiation.
Material and methods: Analysis of dose distributions in the Eclipse radiotherapy planning system (Varian). The techniques of irradiation with IMRT and RapidARC modulated intensity beams with and without boluses are considered. The analysis of dose distributions took into account the limitations of the planning systems when calculating doses in the vicinity of the interfaces between the heterogeneities and used data on the properties of dose distributions.
Results: Demonstrated the need to use boluses. In this case, a high uniformity of dose distribution in the target is achieved. To protect the brain, it is necessary to use irradiation with intensity modulated beams. Irradiation in the RapidARC technique compared with IMRT gives the best dose distribution and the exposure session is shorter in time. Dose loads on the skin at a therapeutic radiation dose of 39 Gy in 13 fractions do not exceed the tolerant levels given in the literature. The irradiation of the presented patient passed without complications.
Conclusion: Irradiation of metastases in the scalp at a dose of 39 Gy in 13 fractions is safe and effective, if sutisfy two rules. You must use a bolus about 0.5 cm thick, the irradiation technique should be rotational beams of modulated intensity (RapidARC, VMAT).
About the Authors
A. V. Nazarenko
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation
Moscow
Russian Federation
Moscow
G. E. Gorlachev
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation
Moscow
Russian Federation
Moscow
T. N. Borisova
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation
Moscow
Russian Federation
Moscow
A. A. Fedorova
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation
Moscow
Russian Federation
Moscow
R. A. Gutnik
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation
Moscow
Russian Federation
Moscow
T. I. Soldatova
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation
Moscow
Russian Federation
Moscow
References
1. Fraas B., Hunt M., Kutcher G. et al. AAPM Task Group 53: Quality assurance for clinical radiotherapy treatment planning // Med. Phys. 2008. Vol. 25. P. 1773–1829.
2. Chester R., Rodica A. et al. Dosimetric considerations for patients with HIP prostheses undergoing pelvic irradiation. AAPM Task Group 63 // Med. Phys. 2003. Vol. 30. №6. P. 1162–1182. DOI: 10.1118/1.1565113.
3. Горлачев Г.E. Исследование дозных полей вблизи границы раздела гетерогенностей при лучевой терапии // Дисс. к.ф-м.н. – М.: МИФИ. 1999.
4. Bentzen S.M., Constine L.S., Deasy J.O. et al. Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues // Int. J. Radiat. Oncol. Biol. Phys. 2010. Vol. 76. № 3. Suppl. S3–S9.
5. Benedict S.H., Yenice K.M., Followill D. et al. Stereotactic body radiation therapy: The report of AAPM Task Group 101 // Med. Phys. 2010. Vol. 37. № 8. P. 4078-4101. DOI: 10.1118/1.3438081.
6. Stewart F.A., Akleyev A.V., Hauer-Jensen et al. ICRP Publication 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs – Threshold Doses for Tissue Reactions in a Radiation Protection Context // Ann. of the ICRP. 2012. Vol. 41(1–2). P. 1–322. DOI: 10.1016/j.icrp.2012.02.001.
7. Hanna G.G. et al. UK Consensus on Normal Tissue Dose Constraints for Stereotactic Radiotherapy // Clin. Oncol. 2017. Vol. 30. № 1. P. 5–14. DOI: 10.1016/j.clon.2017.09.007.
8. Maarten L., Eekers K. et al. Radiation dose constraints for organs at risk in neuro-oncology; the European Particle Therapy Network consensus // Radiother. Oncol. 2018. Vol. 128. № 1. P. 26–36. DOI: 10.1016/j.radonc.2018.05.001.
9. Emami B. Tolerance of normal tissue to therapeutic radiation // Rep. Radiother. Oncol. 2013. Vol. 1. № 1. P. 123–127.
10. Mayer R., Sminia P. Reirradiation tolerance of the human brain // Int. J. Radiat. Oncol. Biol. Phys. 2007. Vol. 70. № 5. P. 1350–1360. DOI: 10.1016/j.ijrobp.2007.08.015.
11. Galkin M. V., Golanov A. V. et al. Successful CyberKnife irradiation of 1000 cc hemicranial meningioma: 6-year follow-up // Cureus. 2015. Vol. 7. № 11. e384. DOI: 10.7759/cureus.384
Review
For citations:
Nazarenko A.V., Gorlachev G.E., Borisova T.N., Fedorova A.A., Gutnik R.A., Soldatova T.I. Dosimetric Analysis of Clinical Case of Radiation Therapy of Metastases in the Head Skin. Journal of oncology: diagnostic radiology and radiotherapy. 2018;1(4):5-13. (In Russ.) https://doi.org/10.37174/2587-7593-2018-1-4-5-13
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