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Intensity modulated radiotherapy (IMRT) in the treatment of children and adolescents--a single institution's experience and a review of the literature.

Authors :
Sterzing F
Stoiber EM
Nill S
Bauer H
Huber P
Debus J
Münter MW
Sterzing, Florian
Stoiber, Eva M
Nill, Simeon
Bauer, Harald
Huber, Peter
Debus, Jürgen
Münter, Marc W
Source :
Radiation Oncology; 2009, Vol. 4, p37-37, 1p
Publication Year :
2009

Abstract

<bold>Background: </bold>While IMRT is widely used in treating complex oncological cases in adults, it is not commonly used in pediatric radiation oncology for a variety of reasons. This report evaluates our 9 year experience using stereotactic-guided, inverse planned intensity-modulated radiotherapy (IMRT) in children and adolescents in the context of the current literature.<bold>Methods: </bold>Between 1999 and 2008 thirty-one children and adolescents with a mean age of 14.2 years (1.5 - 20.5) were treated with IMRT in our department. This heterogeneous group of patients consisted of 20 different tumor entities, with Ewing's sarcoma being the largest (5 patients), followed by juvenile nasopharyngeal fibroma, esthesioneuroblastoma and rhabdomyosarcoma (3 patients each). In addition a review of the available literature reporting on technology, quality, toxicity, outcome and concerns of IMRT was performed.<bold>Results: </bold>With IMRT individualized dose distributions and excellent sparing of organs at risk were obtained in the most challenging cases. This was achieved at the cost of an increased volume of normal tissue receiving low radiation doses. Local control was achieved in 21 patients. 5 patients died due to progressive distant metastases. No severe acute or chronic toxicity was observed.<bold>Conclusion: </bold>IMRT in the treatment of children and adolescents is feasible and was applied safely within the last 9 years at our institution. Several reports in literature show the excellent possibilities of IMRT in selective sparing of organs at risk and achieving local control. In selected cases the quality of IMRT plans increases the therapeutic ratio and outweighs the risk of potentially increased rates of secondary malignancies by the augmented low dose exposure. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
1748717X
Volume :
4
Database :
Complementary Index
Journal :
Radiation Oncology
Publication Type :
Academic Journal
Accession number :
105231144
Full Text :
https://doi.org/10.1186/1748-717X-4-37