Effective heart-sparing whole lung irradiation using volumetric modulated arc therapy: a case report.
IMRT
VMAT
Volumetric modulated arc therapy
Whole lung irradiation
Wilms’ tumor
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
02 Sep 2019
02 Sep 2019
Historique:
received:
14
05
2019
accepted:
30
07
2019
entrez:
3
9
2019
pubmed:
3
9
2019
medline:
6
2
2020
Statut:
epublish
Résumé
Late cardiovascular disease-related adverse events are one of the most common causes of premature mortality among long-term survivors of childhood cancer. As it is difficult to reduce the heart dose with traditional anteroposterior-posteroanterior field whole lung irradiation for pulmonary metastasis, improved radiation techniques are highly desirable. We report a case treated with whole lung irradiation using volumetric modulated arc therapy. A 3-year-old Japanese girl with pulmonary metastases of Wilms' tumor received 12 Gy in 8 fractions of whole lung irradiation using volumetric modulated arc therapy. The treatment was well tolerated, and the course was completed as planned without any toxicity. We found statistically significant reduced volumetric modulated arc therapy irradiation doses to organs at risk relative to those of the standard anteroposterior-posteroanterior field technique. The mean heart dose was 8.5 Gy for volumetric modulated arc therapy and 12.3 Gy for the anteroposterior-posteroanterior field. The doses to liver and thyroid were also more favorable with volumetric modulated arc therapy than with the anteroposterior-posteroanterior field technique. We confirmed the dosimetric advantages of volumetric modulated arc therapy over anteroposterior-posteroanterior field in whole lung irradiation in terms of superior normal organ protection. Effective heart sparing is possible for whole lung irradiation using volumetric modulated arc therapy. Large-scale studies using standardized procedures should be conducted to validate our results.
Sections du résumé
BACKGROUND
BACKGROUND
Late cardiovascular disease-related adverse events are one of the most common causes of premature mortality among long-term survivors of childhood cancer. As it is difficult to reduce the heart dose with traditional anteroposterior-posteroanterior field whole lung irradiation for pulmonary metastasis, improved radiation techniques are highly desirable. We report a case treated with whole lung irradiation using volumetric modulated arc therapy.
CASE PRESENTATION
METHODS
A 3-year-old Japanese girl with pulmonary metastases of Wilms' tumor received 12 Gy in 8 fractions of whole lung irradiation using volumetric modulated arc therapy. The treatment was well tolerated, and the course was completed as planned without any toxicity. We found statistically significant reduced volumetric modulated arc therapy irradiation doses to organs at risk relative to those of the standard anteroposterior-posteroanterior field technique. The mean heart dose was 8.5 Gy for volumetric modulated arc therapy and 12.3 Gy for the anteroposterior-posteroanterior field. The doses to liver and thyroid were also more favorable with volumetric modulated arc therapy than with the anteroposterior-posteroanterior field technique. We confirmed the dosimetric advantages of volumetric modulated arc therapy over anteroposterior-posteroanterior field in whole lung irradiation in terms of superior normal organ protection.
CONCLUSIONS
CONCLUSIONS
Effective heart sparing is possible for whole lung irradiation using volumetric modulated arc therapy. Large-scale studies using standardized procedures should be conducted to validate our results.
Identifiants
pubmed: 31474226
doi: 10.1186/s13256-019-2209-2
pii: 10.1186/s13256-019-2209-2
pmc: PMC6717977
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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