Document Detail


Comparison of risk of radiogenic second cancer following photon and proton craniospinal irradiation for a pediatric medulloblastoma patient.
MedLine Citation:
PMID:  23322160     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pediatric patients who received radiation therapy are at risk of developing side effects such as radiogenic second cancer. We compared proton and photon therapies in terms of the predicted risk of second cancers for a 4 year old medulloblastoma patient receiving craniospinal irradiation (CSI). Two CSI treatment plans with 23.4 Gy or Gy (RBE) prescribed dose were computed: a three-field 6 MV photon therapy plan and a four-field proton therapy plan. The primary doses for both plans were determined using a commercial treatment planning system. Stray radiation doses for proton therapy were determined from Monte Carlo simulations, and stray radiation doses for photon therapy were determined from measured data. Dose-risk models based on the Biological Effects of Ionization Radiation VII report were used to estimate the risk of second cancer in eight tissues/organs. Baseline predictions of the relative risk for each organ were always less for proton CSI than for photon CSI at all attained ages. The total lifetime attributable risk of the incidence of second cancer considered after proton CSI was much lower than that after photon CSI, and the ratio of lifetime risk was 0.18. Uncertainty analysis revealed that the qualitative findings of this study were insensitive to any plausible changes of dose-risk models and mean radiation weighting factor for neutrons. Proton therapy confers lower predicted risk of second cancer than photon therapy for the pediatric medulloblastoma patient.
Authors:
Rui Zhang; Rebecca M Howell; Annelise Giebeler; Phillip J Taddei; Anita Mahajan; Wayne D Newhauser
Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2013-01-16
Journal Detail:
Title:  Physics in medicine and biology     Volume:  58     ISSN:  1361-6560     ISO Abbreviation:  Phys Med Biol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-01     Completed Date:  2013-08-06     Revised Date:  2014-02-24    
Medline Journal Info:
Nlm Unique ID:  0401220     Medline TA:  Phys Med Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  807-23     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Central Nervous System Neoplasms / pathology,  radiotherapy*
Child, Preschool
Craniospinal Irradiation / adverse effects*
Dose-Response Relationship, Radiation
Humans
Male
Medulloblastoma / pathology,  radiotherapy*
Monte Carlo Method
Neoplasms, Radiation-Induced / diagnosis*
Neoplasms, Second Primary / diagnosis,  etiology*
Proton Therapy / adverse effects*,  methods
Radiotherapy, Intensity-Modulated / methods
Risk
Tissue Distribution
Tomography, X-Ray Computed / methods
Grant Support
ID/Acronym/Agency:
1R01CA131463-01A1/CA/NCI NIH HHS; K01TW008409/TW/FIC NIH HHS; R01 CA131463/CA/NCI NIH HHS
Comments/Corrections

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