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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.
Int. J. Radiat. Oncol. Biol. Phys. 120, 439-453 (2024)
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.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Childhood Cancer ; Radiation Dosimetry ; Healthy Organs Radiation Dose; Childhood-cancer; Alkylating-agents; Thyroid-cancer; Radiotherapy; Survivors; Leukemia; Reconstruction; Neoplasms; Disease; Volume
ISSN (print) / ISBN
0360-3016
e-ISSN
0360-3016
Quellenangaben
Volume: 120,
Issue: 2,
Pages: 439-453
Publisher
Elsevier
Publishing Place
Ste 800, 230 Park Ave, New York, Ny 10169 Usa
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Radiation Medicine (IRM)
Grants
Children with Cancer UK
Swiss Cancer Research Foundation
Swiss National Science Foundation
Dutch Cancer Society
Children Cancer Free Foundation (KiKa)
Norwegian Childhood Cancer Foundation
Swiss Cancer League
Swiss Cancer Research Foundation
Swiss National Science Foundation
Dutch Cancer Society
Children Cancer Free Foundation (KiKa)
Norwegian Childhood Cancer Foundation
Swiss Cancer League