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Helical Tomotherapy in Children and Adolescents: Dosimetric Comparisons, Opportunities and Issues
Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico- National Cancer Institute/Via Franco Gallini, 2 33081 Aviano (PN) Italy
Department of Radiation Therapy, Centro di Riferimento Oncologico- National Cancer Institute/Via Franco Gallini, 2 33081 Aviano (PN) Italy
Department of Medical Physics, Centro di Riferimento Oncologico- National Cancer Institute/Via Franco Gallini, 2 33081 Aviano (PN) Italy
Seconda Università di Napoli, Napoli 80138, Italy
* Author to whom correspondence should be addressed.
Received: 13 September 2011; in revised form: 7 October 2011 / Accepted: 17 October 2011 / Published: 25 October 2011
Abstract: Helical Tomotherapy (HT) is a highly conformal image-guided radiation technique, introduced into clinical routine in 2006 at the Centro di Riferimento Oncologico Aviano (Italy). With this new technology, intensity-modulated radiotherapy (IMRT) is delivered using a helicoidal method. Here we present our dosimetric experiences using HT in 100 children, adolescents and young adults treated from May 2006 to February 2011. The median age of the patients was 13 years (range 1–24). The most common treated site was the central nervous system (50; of these, 24 were craniospinal irradiations), followed by thorax (22), head and neck (10), abdomen and pelvis (11), and limbs (7). The use of HT was calculated in accordance to the target dose conformation, the target size and shape, the dose to critical organs adjacent to the target, simultaneous treatment of multiple targets, and re-irradiation. HT has demonstrated to improve target volume dose homogeneity and the sparing of critical structures, when compared to 3D Linac-based radiotherapy (RT). In standard cases this technique represented a comparable alternative to IMRT delivered with conventional linear accelerator. In certain cases (e.g., craniospinal and pleural treatments) only HT generated adequate treatment plans with good target volume coverage. However, the gain in target conformality should be balanced with the spread of low-doses to distant areas. This remains an open issue for the potential risk of secondary malignancies (SMNs) and longer follow-up is mandatory.
Keywords: paediatric oncology; helical tomotherapy; intensity modulated radiotherapy; 3D conventional radiotherapy; treatment planning; organs at risk; late effects; dose homogeneity
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MDPI and ACS Style
Mascarin, M.; Giugliano, F.M.; Coassin, E.; Drigo, A.; Chiovati, P.; Dassie, A.; Franchin, G.; Minatel, E.; Trovò, M.G. Helical Tomotherapy in Children and Adolescents: Dosimetric Comparisons, Opportunities and Issues. Cancers 2011, 3, 3972-3990.
Mascarin M, Giugliano FM, Coassin E, Drigo A, Chiovati P, Dassie A, Franchin G, Minatel E, Trovò MG. Helical Tomotherapy in Children and Adolescents: Dosimetric Comparisons, Opportunities and Issues. Cancers. 2011; 3(4):3972-3990.
Mascarin, Maurizio; Giugliano, Francesca Maria; Coassin, Elisa; Drigo, Annalisa; Chiovati, Paola; Dassie, Andrea; Franchin, Giovanni; Minatel, Emilio; Trovò, Mauro Gaetano. 2011. "Helical Tomotherapy in Children and Adolescents: Dosimetric Comparisons, Opportunities and Issues." Cancers 3, no. 4: 3972-3990.