A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Radiation doses received by major organs at risk in children and young adolescents treated for cancer with external beam radiation therapy: a large-scale study from 12 European countries
Tekijät: Diallo Ibrahima, Allodji Rodrigue S., Veres Cristina, Bolle Stéphanie, Llanas Damien, Ezzouhri Safaa, Zrafi Wael, Debiche Ghazi, Souchard Vincent, Fauchery Romain, Haddy Nadia, Journy Neige, Demoor-Goldschmidt Charlotte, Winter David L., Hjorth Lars, Wiebe Thomas, Haupt Riccardo, Robert Charlotte, Kremer Leontien, Bardi Edit, Sacerdote Carlotta, Terenziani Monica, Kuehni Claudia E., Schindera Christina, Skinner Roderick, Winther Jeanette Falck, Lähteenmäki Päivi, Byrn Julianne, Jakab Zsuzsanna, Cardis Elisabeth, Pasqual Elisa, Tapio Soile, Baatout Sarah, Atkinson Mike, Benotmane Mohammed Abderrafi, Sugden Elaine, Zaletel Lorna Zadravec, Ronckers Cecile, Reulen Raoul C., Hawkins Mike M., de Vathaire Florent
Kustantaja: Pergamon Press
Julkaisuvuosi: 2024
Journal: International Journal of Radiation Oncology - Biology - Physics
Tietokannassa oleva lehden nimi: International journal of radiation oncology, biology, physics
Lehden akronyymi: Int J Radiat Oncol Biol Phys
Vuosikerta: 120
Numero: 2
Aloitussivu: 439
Lopetussivu: 453
ISSN: 0360-3016
eISSN: 1879-355X
DOI: https://doi.org/10.1016/j.ijrobp.2024.03.032
Verkko-osoite: https://doi.org/10.1016/j.ijrobp.2024.03.032
Background
Childhood cancer survivors are at high risk of long-term iatrogenic events, in particular those treated with radiotherapy. The prediction of risk of such events is mainly based on the knowledge of the radiation dose received to healthy organs and tissues during treatment of childhood cancer diagnosed decades ago.
Purpose
We aimed to set up a standardised organ dose table in order to help former patients and clinician in charge of long term follow-up clinics.
Material and methods
We performed whole body dosimetric reconstruction for 2646 patients from 12 European Countries treated between 1941 and 2006 (median: 1976). Most planning were 2D or 3D, 46% of patients were treated using Cobalt 60 and 41% using linear accelerator, the median prescribed dose being 27.2 Gy (IQ1-IQ3: 17.6-40.0 Gy), A patient specific voxel-based anthropomorphic phantom with more than 200 anatomical structures or sub-structures delineated as a surrogate of each subject's anatomy was used. The radiation therapy was simulated with a treatment planning system (TPS) based on available treatment information. The radiation dose received by any organ of the body was estimated by extending the TPS dose calculation to the whole-body, by type and localisation of childhood cancer.
Results
The integral dose and normal-tissue doses to most of the 23 considered organs increased between the 1950’s and the 1970’s and decreased or plateaued thereafter. Whatever the organ considered, the type of childhood cancer explained most of the variability in organ dose. The country of treatment explained only a small part of the variability.
Conclusion
The detailed dose estimates provide very useful information for former patients or clinicians who have only limited knowledge about radiation therapy protocols or techniques, but who know the type and site of childhood cancer, gender, age and year of treatment. This will allow better prediction of the long-term risk of iatrogenic events and better referral to long-term follow-up clinics.