Evaluation of permanent alopecia in pediatric medulloblastoma patients treated with proton radiation

Radiation Oncology

Torunn I Yock¹  Nancy J Tarbell¹  Shannon M MacDonald¹  Judith Adams¹  Brian A Winey¹  Harald Paganetti¹  Chul Hee Min² 

[1] Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;Department of Radiation Convergence Engineering, Yonsei University, Wonju, Korea

关键词: Monte Carlo simulation;    Pediatric medulloblastoma;    Proton therapy;    Permanent alopecia;   

Others  :  1151007
DOI  :  10.1186/s13014-014-0220-8

 received in 2014-03-24, accepted in 2014-09-23,  发布年份 2014

【 摘 要 】

Background

To precisely calculate skin dose and thus to evaluate the relationship between the skin dose and permanent alopecia for pediatric medulloblastoma patients treated with proton beams.

Methods

The dosimetry and alopecia outcomes of 12 children with medulloblastoma (ages 4-15 years) comprise the study cohort. Permanent alopecia was assessed and graded after completion of the entire therapy. Skin threshold doses of permanent alopecia were calculated based on the skin dose from the craniospinal irradiation (CSI) plan using the concept of generalized equivalent uniform dose (gEUD) and accounting for chemotherapy intensity. Monte Carlo simulations were employed to accurately assess uncertainties due to beam range prediction and secondary particles.

Results

Increasing the dose of the CSI field or the dose given by the boost field to the posterior fossa increased total skin dose delivered in that region. It was found that permanent alopecia could be correlated with CSI dose with a threshold of about 21 Gy (relative biological effectiveness, RBE) with high dose chemotherapy and 30 Gy (RBE) with conventional chemotherapy.

Conclusions

Our results based on 12 patients provide a relationship between the skin dose and permanent alopecia for pediatric medulloblastoma patients treated with protons. The alopecia risk as assessed with gEUD could be predicted based on the treatment plan information.

【 授权许可】

   
2014 Min et al.; licensee BioMed Central Ltd.

【 图 表 】

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