PMID- 36257232
OWN - NLM
STAT- MEDLINE
DCOM- 20221129
LR  - 20221129
IS  - 1724-191X (Electronic)
IS  - 1120-1797 (Linking)
VI  - 103
DP  - 2022 Nov
TI  - 3D-CRT, IMRT and VMAT for flank irradiation due to pediatric Wilms tumor: A 
      comparative planning study with XCAT phantoms.
PG  - 89-97
LID - S1120-1797(22)02063-4 [pii]
LID - 10.1016/j.ejmp.2022.10.002 [doi]
AB  - PURPOSE: To compare the dosimetric parameters and radiogenic risks from 3D-CRT, 
      IMRT and VMAT for flank irradiation due to pediatric Wilms tumor. METHODS: Two 
      computational XCAT phantoms simulating an average 5- and 10-year-old patient were 
      used. Four different planning target volumes (PTVs) for right flank (RF) and left 
      flank (LF) irradiation with or without paraaortic lymph nodes (LNs) and eight 
      surrounding organs-at-risk (OARs) were contoured on the phantoms' CT sections. 
      Forty-eight 3D-CRT, IMRT and VMAT plans were created using 6 and 10-MV photons on 
      the two phantoms. The target coverage index (TCI), homogeneity index (HI), 
      conformity index (CI), conformation number (CN) and OAR exposure were determined 
      through dose-volume histogram (DVH) analysis. Second cancer risks were estimated 
      using a non-linear model and DVH data. RESULTS: The IMRT and VMAT for LF + LN and 
      RF + LN irradiation reduced the radiation dose to four to six out of the eight 
      OARs compared to 3D-CRT. Conventional treatment provided a better organ sparing 
      for RF and LF irradiation. The IMRT and VMAT led to superior planning parameters 
      in respect to 3D-CRT for all PTVs and both patient's ages (3D-CRT: TCI = 59.80 % 
      - 82.26 %, CI = 0.55-0.81, CN = 0.40-0.64, HI = 1.11-1.15; IMRT: TCI = 96.04 % - 
      99.72 %, CI = 0.85-0.91, CN = 0.85-0.88, HI = 1.03-1.05; VMAT: TCI = 96.02 % - 
      99.69 %, CI = 0.86-0.91, CN = 0.85-0.89, HI = 1.03-1.06). The 
      excess-absolute-risk for developing secondary small intestine, liver and stomach 
      malignancies from 3D-CRT were (7.99-19.32) x 10(-4), (0.29-3.83) x 10(-4) and 
      (0.37-4.50) x 10(-4) persons-year, respectively. The corresponding risks from 
      intensity modulated techniques reached to 22.26 x 10(-4), 4.58 x 10(-4) and 
      5.42 x 10(-4) persons-year. CONCLUSIONS: This dataset related to plan quality, 
      radiation dose and risks to OARs allows the selection of the proper treatment 
      technique for flank irradiation based on the patient's age and target site.
CI  - Copyright (c) 2022. Published by Elsevier Ltd.
FAU - Mazonakis, Michalis
AU  - Mazonakis M
AD  - Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 
      2208, 71003 Iraklion, Crete, Greece. Electronic address: mazonak@uoc.gr.
FAU - Lyraraki, Efrosyni
AU  - Lyraraki E
AD  - Department of Radiation Oncology, University Hospital of Iraklion, 71110 
      Iraklion, Crete, Greece.
FAU - Tolia, Maria
AU  - Tolia M
AD  - Department of Radiation Oncology, University Hospital of Iraklion, 71110 
      Iraklion, Crete, Greece.
FAU - Damilakis, John
AU  - Damilakis J
AD  - Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 
      2208, 71003 Iraklion, Crete, Greece.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20221017
PL  - Italy
TA  - Phys Med
JT  - Physica medica : PM : an international journal devoted to the applications of 
      physics to medicine and biology : official journal of the Italian Association of 
      Biomedical Physics (AIFB)
JID - 9302888
SB  - IM
MH  - Child
MH  - Humans
MH  - Child, Preschool
MH  - *Radiotherapy, Intensity-Modulated/adverse effects/methods
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - *Radiotherapy, Conformal/methods
MH  - *Wilms Tumor/radiotherapy
OTO - NOTNLM
OT  - Radiation risks
OT  - Radiation therapy
OT  - Wilms tumor
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2022/10/19 06:00
MHDA- 2022/11/30 06:00
CRDT- 2022/10/18 18:26
PHST- 2022/03/10 00:00 [received]
PHST- 2022/06/02 00:00 [revised]
PHST- 2022/10/07 00:00 [accepted]
PHST- 2022/10/19 06:00 [pubmed]
PHST- 2022/11/30 06:00 [medline]
PHST- 2022/10/18 18:26 [entrez]
AID - S1120-1797(22)02063-4 [pii]
AID - 10.1016/j.ejmp.2022.10.002 [doi]
PST - ppublish
SO  - Phys Med. 2022 Nov;103:89-97. doi: 10.1016/j.ejmp.2022.10.002. Epub 2022 Oct 17.