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Simple template-based optimization for pediatric total lymphoid irradiation (TLI) radiotherapy treatments.
Ferrer, C; Huertas, C; Plaza, R; de la Monja, P; Ocanto, A; Escribano, A; Pérez, A; Sáez, M.
Afiliación
  • Ferrer C; Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain. Electronic address: carlos.ferrer@salud.madrid.org.
  • Huertas C; Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain.
  • Plaza R; Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain.
  • de la Monja P; Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain.
  • Ocanto A; Radiation Oncology Department, Hospital Universitario La Paz, Madrid, Spain.
  • Escribano A; Radiation Oncology Department, Hospital Universitario La Paz, Madrid, Spain.
  • Pérez A; Pediatric Hematology-Oncology Department, Hospital Universitario La Paz, Madrid, Spain.
  • Sáez M; Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain.
Med Dosim ; 46(2): 201-207, 2021.
Article en En | MEDLINE | ID: mdl-33309515
Total lymphoid irradiation (TLI) is used in the management of pediatric allogeneic hematopoietic stem cell transplantation (HSCT. This work aims to simplify the treatment planning process for TLI via a proposed template using the volumetric modulated arc therapy (VMAT) technique. Fifteen pediatric patients were planned, prescribed to 8 Gy in 4 fractions. Cost functions included in the template were the ones for the planning target volume (PTV), and conformality cost function (CCF) for the rest of the patient's volume. Conformity index (CI), homogeneity index (HI), conformation number (CN), gradient index (GI), integral dose, and doses to the organs at risk achieved with the template were reported. Cost function influence over various indexes was studied by Wilcoxon signed ranks test. Same 15 patients were planned with 3-dimensional conventional radiotherapy (3D-CRT) technique for comparison. Mean CI and HI were 1.33 and 0.13, respectively, which indicates good dose conformation and homogeneity. Mean CN and GI values were 0.69 and 4.51, respectively. Mean PTV coverage was reached (V100% > 95%). No correlation between the CCF and indexes values was found (p > 0.05). Doses to organs at risk (OARs) were as low as possible without losing PTV coverage. VMAT plan showed higher levels of conformation and similar homogeneity as 3D-CRT plans. Doses to OARs were inferior with VMAT except for the right kidney. The proposed template simplifies the planning of TLI treatments, and it is able to create acceptable plans with little modification in order to reduce doses to certain organs like the kidneys or the heart. VMAT technique showed higher conformation and lower doses to OAR compared to 3D-CRT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Irradiación Linfática / Radioterapia de Intensidad Modulada Tipo de estudio: Etiology_studies Límite: Child / Humans Idioma: En Revista: Med Dosim Asunto de la revista: RADIOTERAPIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Irradiación Linfática / Radioterapia de Intensidad Modulada Tipo de estudio: Etiology_studies Límite: Child / Humans Idioma: En Revista: Med Dosim Asunto de la revista: RADIOTERAPIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos