Proton therapy of a pregnant patient with nasopharyngeal carcinoma
Background and purpose: Radiotherapy during pregnancy is rarely administered due to lack of data and practical challenges. This is the first detailed report of proton therapy as cancer treatment for a pregnant patient with nasopharyngeal carcinoma. Materials and methods: Pencil beam scanning proton...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-07-01
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| Series: | Clinical and Translational Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630822000374 |
| _version_ | 1818252606750851072 |
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| author | Joosje H. Heimovaara Jeroen Blommaert Jeffrey Free René A. Bolt Elske M. Gort Tom Depuydt Cristina Boso Martinez Mirthe H. Schoots Mathilde van Gerwen Marry van den Heuvel-Eibrink Johannes A. Langendijk Carolien P. Schröder Frédéric Amant Sanne J. Gordijn Edwin Oldehinkel |
| author_facet | Joosje H. Heimovaara Jeroen Blommaert Jeffrey Free René A. Bolt Elske M. Gort Tom Depuydt Cristina Boso Martinez Mirthe H. Schoots Mathilde van Gerwen Marry van den Heuvel-Eibrink Johannes A. Langendijk Carolien P. Schröder Frédéric Amant Sanne J. Gordijn Edwin Oldehinkel |
| author_sort | Joosje H. Heimovaara |
| collection | DOAJ |
| description | Background and purpose: Radiotherapy during pregnancy is rarely administered due to lack of data and practical challenges. This is the first detailed report of proton therapy as cancer treatment for a pregnant patient with nasopharyngeal carcinoma. Materials and methods: Pencil beam scanning proton therapy was prescribed to a pregnant patient to a total dose of 70 Gy (RBE) to the therapeutic CTV and 54.25 Gy to the prophylactic CTV, delivered in 35 fractions with a simultaneous integrated boost technique. Results: Phantom measurements showed a thirty-fold decrease in fetal radiation dose when using proton compared to photon therapy, with a total fetal dose of 5.5 mSv for the complete proton treatment, compared to 185 and 298 mSv for the photon treatment with and without lead shielding, respectively. After adminstering proton therapy during pregnancy, at 39 weeks of gestation, a healthy boy with a birthweight on the 83th percentile was delivered. Pediatric follow-up at 2 months of age of the offspring showed normal growth and age-adequate motor development with no signs of neurological problems. MR follow-up of the tumor 3 months after the end of treatment showed complete remission. Conclusion: This case demonstrates the potential of proton therapy for treatment during pregnancy.Compared to photon therapy, proton therapy can significantly limit fetal dose, while simultaneously offering a more optimized treatment to the patient. |
| first_indexed | 2024-12-12T16:26:51Z |
| format | Article |
| id | doaj.art-887061fa87194c2bb5568c73d89c463b |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-12-12T16:26:51Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-887061fa87194c2bb5568c73d89c463b2022-12-22T00:18:51ZengElsevierClinical and Translational Radiation Oncology2405-63082022-07-01353336Proton therapy of a pregnant patient with nasopharyngeal carcinomaJoosje H. Heimovaara0Jeroen Blommaert1Jeffrey Free2René A. Bolt3Elske M. Gort4Tom Depuydt5Cristina Boso Martinez6Mirthe H. Schoots7Mathilde van Gerwen8Marry van den Heuvel-Eibrink9Johannes A. Langendijk10Carolien P. Schröder11Frédéric Amant12Sanne J. Gordijn13Edwin Oldehinkel14Department of Oncology, KU Leuven, Leuven, Belgium; Department of Gynecologic Oncology, Netherlands Cancer Institute and Amsterdam University Medical Center, Amsterdam, the NetherlandsDepartment of Oncology, KU Leuven, Leuven, BelgiumDepartment of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsDepartment of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsDepartment of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsDepartment of Oncology, KU Leuven, Leuven, Belgium; Department of Radiation Oncology, University Hospitals Leuven, Leuven, BelgiumDepartment of Radiation Oncology, University Hospitals Leuven, Leuven, BelgiumDepartment of Pathology and Medical Biology, Pathology Section, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsDepartment of Gynecologic Oncology, Netherlands Cancer Institute and Amsterdam University Medical Center, Amsterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the NetherlandsPrincess Máxima Center for Pediatric Oncology, Utrecht, the NetherlandsDepartment of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsDepartment of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute and Amsterdam University Medical Center, Amsterdam, the NetherlandsDepartment of Oncology, KU Leuven, Leuven, Belgium; Department of Gynecologic Oncology, Netherlands Cancer Institute and Amsterdam University Medical Center, Amsterdam, the Netherlands; Department of Gynecologic Oncology, University Hospitals Leuven, Leuven, BelgiumDepartment of Obstetrics and Gynecology, University Medical Centre Groningen, University of Groningen, Groningen, the NetherlandsDepartment of Oncology, KU Leuven, Leuven, Belgium; Corresponding author.Background and purpose: Radiotherapy during pregnancy is rarely administered due to lack of data and practical challenges. This is the first detailed report of proton therapy as cancer treatment for a pregnant patient with nasopharyngeal carcinoma. Materials and methods: Pencil beam scanning proton therapy was prescribed to a pregnant patient to a total dose of 70 Gy (RBE) to the therapeutic CTV and 54.25 Gy to the prophylactic CTV, delivered in 35 fractions with a simultaneous integrated boost technique. Results: Phantom measurements showed a thirty-fold decrease in fetal radiation dose when using proton compared to photon therapy, with a total fetal dose of 5.5 mSv for the complete proton treatment, compared to 185 and 298 mSv for the photon treatment with and without lead shielding, respectively. After adminstering proton therapy during pregnancy, at 39 weeks of gestation, a healthy boy with a birthweight on the 83th percentile was delivered. Pediatric follow-up at 2 months of age of the offspring showed normal growth and age-adequate motor development with no signs of neurological problems. MR follow-up of the tumor 3 months after the end of treatment showed complete remission. Conclusion: This case demonstrates the potential of proton therapy for treatment during pregnancy.Compared to photon therapy, proton therapy can significantly limit fetal dose, while simultaneously offering a more optimized treatment to the patient.http://www.sciencedirect.com/science/article/pii/S2405630822000374 |
| spellingShingle | Joosje H. Heimovaara Jeroen Blommaert Jeffrey Free René A. Bolt Elske M. Gort Tom Depuydt Cristina Boso Martinez Mirthe H. Schoots Mathilde van Gerwen Marry van den Heuvel-Eibrink Johannes A. Langendijk Carolien P. Schröder Frédéric Amant Sanne J. Gordijn Edwin Oldehinkel Proton therapy of a pregnant patient with nasopharyngeal carcinoma Clinical and Translational Radiation Oncology |
| title | Proton therapy of a pregnant patient with nasopharyngeal carcinoma |
| title_full | Proton therapy of a pregnant patient with nasopharyngeal carcinoma |
| title_fullStr | Proton therapy of a pregnant patient with nasopharyngeal carcinoma |
| title_full_unstemmed | Proton therapy of a pregnant patient with nasopharyngeal carcinoma |
| title_short | Proton therapy of a pregnant patient with nasopharyngeal carcinoma |
| title_sort | proton therapy of a pregnant patient with nasopharyngeal carcinoma |
| url | http://www.sciencedirect.com/science/article/pii/S2405630822000374 |
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