Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy
Optimizing irradiation protocols for pregnant women is challenging, because there are few cases and a dearth of fetal dosimetry data. We cared for a 36-year-old pregnant woman with tongue cancer. Prior to treatment, we compared three intensity-modulated radiation therapy (IMRT) techniques, including...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | Clinical and Translational Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630819301028 |
| _version_ | 1818461175504961536 |
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| author | Wataru Takahashi Kanabu Nawa Akihiro Haga Hideomi Yamashita Toshikazu Imae Mami Ogita Kae Okuma Osamu Abe Keiichi Nakagawa |
| author_facet | Wataru Takahashi Kanabu Nawa Akihiro Haga Hideomi Yamashita Toshikazu Imae Mami Ogita Kae Okuma Osamu Abe Keiichi Nakagawa |
| author_sort | Wataru Takahashi |
| collection | DOAJ |
| description | Optimizing irradiation protocols for pregnant women is challenging, because there are few cases and a dearth of fetal dosimetry data. We cared for a 36-year-old pregnant woman with tongue cancer. Prior to treatment, we compared three intensity-modulated radiation therapy (IMRT) techniques, including helical tomotherapy, volumetric arc therapy (VMAT), and flattening-filter free VMAT (FFF-VMAT) using treatment planning software. FFF-VMAT achieved the minimum fetal exposure and was selected as the optimal modality. We prescribed 66 Gy to the involved nodes, 60 Gy to the tumor bed and ipsilateral neck, and 54 Gy to the contralateral neck over 33 fractions. To confirm the out-of-field exposure per fraction, surface doses and the rectal dose were measured during FFF-VMAT delivery. Postoperative chemoradiotherapy was delivered using IMRT and a cisplatin regimen. Without any shielding, the total fetal dose was 0.03 Gy, within the limits established by the ICRP. A healthy girl was born vaginally at 37 weeks’ gestation. Keywords: Pregnancy, Tongue cancer, Fetal dose, Intensity-modulated radiation therapy, Flattening filter-free |
| first_indexed | 2024-12-14T23:41:58Z |
| format | Article |
| id | doaj.art-add36de95f2949e689048a985b012057 |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-12-14T23:41:58Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-add36de95f2949e689048a985b0120572022-12-21T22:43:30ZengElsevierClinical and Translational Radiation Oncology2405-63082020-01-0120912Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancyWataru Takahashi0Kanabu Nawa1Akihiro Haga2Hideomi Yamashita3Toshikazu Imae4Mami Ogita5Kae Okuma6Osamu Abe7Keiichi Nakagawa8Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan; Corresponding author at: Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.Department of Radiology, The University of Tokyo Hospital, Tokyo, JapanDepartment of Medical Image Informatics, Tokushima University, Tokushima, JapanDepartment of Radiology, The University of Tokyo Hospital, Tokyo, JapanDepartment of Radiology, The University of Tokyo Hospital, Tokyo, JapanDepartment of Radiology, The University of Tokyo Hospital, Tokyo, JapanDepartment of Radiology, The University of Tokyo Hospital, Tokyo, JapanDepartment of Radiology, The University of Tokyo Hospital, Tokyo, JapanDepartment of Radiology, The University of Tokyo Hospital, Tokyo, JapanOptimizing irradiation protocols for pregnant women is challenging, because there are few cases and a dearth of fetal dosimetry data. We cared for a 36-year-old pregnant woman with tongue cancer. Prior to treatment, we compared three intensity-modulated radiation therapy (IMRT) techniques, including helical tomotherapy, volumetric arc therapy (VMAT), and flattening-filter free VMAT (FFF-VMAT) using treatment planning software. FFF-VMAT achieved the minimum fetal exposure and was selected as the optimal modality. We prescribed 66 Gy to the involved nodes, 60 Gy to the tumor bed and ipsilateral neck, and 54 Gy to the contralateral neck over 33 fractions. To confirm the out-of-field exposure per fraction, surface doses and the rectal dose were measured during FFF-VMAT delivery. Postoperative chemoradiotherapy was delivered using IMRT and a cisplatin regimen. Without any shielding, the total fetal dose was 0.03 Gy, within the limits established by the ICRP. A healthy girl was born vaginally at 37 weeks’ gestation. Keywords: Pregnancy, Tongue cancer, Fetal dose, Intensity-modulated radiation therapy, Flattening filter-freehttp://www.sciencedirect.com/science/article/pii/S2405630819301028 |
| spellingShingle | Wataru Takahashi Kanabu Nawa Akihiro Haga Hideomi Yamashita Toshikazu Imae Mami Ogita Kae Okuma Osamu Abe Keiichi Nakagawa Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy Clinical and Translational Radiation Oncology |
| title | Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy |
| title_full | Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy |
| title_fullStr | Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy |
| title_full_unstemmed | Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy |
| title_short | Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy |
| title_sort | acceptable fetal dose using flattening filter free volumetric arc therapy fff vmat in postoperative chemoradiotherapy of tongue cancer during pregnancy |
| url | http://www.sciencedirect.com/science/article/pii/S2405630819301028 |
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