7
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Monte Carlo study for designing a dedicated `D'-shaped collimator used in the external beam radiotherapy of retinoblastoma patients

      Preprint
      , , ,

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose: The purpose of the present article is to propose a modified version of the D-shaped collimator used at the Univ. Hosp. of Essen for retinoblastoma treatment that reduces even further the irradiation field with the scope to reduce the risk of radio-induced secondary malignancies. The new dedicated D-shaped collimator is easier to build and produces dose distributions that only differ on the field size with respect to the dose distributions obtained by the current collimator in use. Methods: The Monte Carlo code PENELOPE was used to study the effect that the structural elements of the collimator have on the absorbed dose distribution. The radiation transport through a Varian Clinac 2100 C/D operating at 6MV was simulated in order to tally phase-space files which were used as radiation sources to simulate the considered collimators and the subsequent dose distributions. Results: The proposed collimator delivers a dose distribution which is 2.4cm wide along the inferior-superior direction of the eyeball. This width is 0.3cm narrower than that of the dose distribution obtained with the collimator currently in use. The other relevant characteristics of the dose distribution obtained with the new collimator, namely, depth doses, penumbrae width and shape of the lateral profiles, are statistically compatible with the results obtained for the collimator in use. Conclusions: The smaller field size delivered by the proposed collimator still fully covers the planning target volume with at least 95% of the maximum dose at a depth of 2cm and provides a safety margin of 0.2cm, so ensuring an adequate treatment while reducing the dose absorbed by surrounding structures of the eye.

          Related collections

          Most cited references16

          • Record: found
          • Abstract: found
          • Article: not found

          Intra-arterial chemotherapy for the management of retinoblastoma: four-year experience.

          To determine whether intra-arterial chemotherapy is safe and effective in advanced intraocular retinoblastoma. Retinoblastoma often presents with advanced intraocular disease and, despite conventional treatment with intravenous chemotherapy and external beam radiation therapy, may still require enucleation. Single-arm, prospective registry from May 30, 2006, to May 30, 2010, at an ophthalmic oncology referral center with ambulatory care. A total of 95 eyes of 78 patients with unilateral or bilateral retinoblastoma were treated. The intervention was selective catheterization of the ophthalmic artery and injection of chemotherapy, usually melphalan with or without topotecan. Drug dosage was determined by age and angioanatomy. The main outcome measures were procedural success, event-free (enucleation or radiotherapy) ocular survival, and ocular and extraocular complications. Catheterization succeeded in 98.5% of procedures. There were 289 chemotherapy injections (median, 3 per eye). The Kaplan-Meier estimates of ocular event-free survival rates at 2 years were 70.0% (95% confidence interval, 57.9%-82.2%) for all eyes, 81.7% (95% confidence interval, 66.8%-96.6%) for eyes that received intra-arterial chemotherapy as primary treatment, and 58.4% (95% confidence interval, 39.5%-77.2%) for eyes that had previous treatment failure with intravenous chemotherapy and/or external beam radiation therapy. There were no permanent extraocular complications. Our experience suggests that intra-arterial chemotherapy is safe and effective in the treatment of advanced intraocular retinoblastoma.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Carboplatin-associated ototoxicity in children with retinoblastoma.

            Carboplatin-induced ototoxicity remains poorly defined but is of potential great consequence in children with retinoblastoma. We retrospectively assessed the incidence of ototoxicity and its risk factors in children with retinoblastoma who were treated with carboplatin. We reviewed the audiologic test results of 60 patients with retinoblastoma who received front-line treatment with systemic carboplatin and vincristine according to the St Jude RET-3 protocol (n = 23) or best clinical management (n = 37). Ototoxicity was evaluated by three different grading systems. Twelve patients (20%) developed ototoxicity at some time after treatment initiation; however, ototoxicity resolved in two patients, and thus,10 patients (17%) had sustained hearing loss as documented at their most recent audiologic evaluation. Nine of these 10 patients had grade 3 or 4 ototoxicity, and nine patients were less than 6 months of age at the start of chemotherapy. Age at the start of chemotherapy was the only risk factor identified as a significant predictor of sustained hearing loss. Younger age was associated with an increased incidence of hearing loss. The different ototoxicity grading systems showed good overall agreement in the identification of patients with ototoxicity. Agreement was greatest between the Brock and Children's Cancer Group systems. We found that young patients with retinoblastoma who were treated with systemic carboplatin had a higher incidence of ototoxicity than previously reported. Younger patients (< 6 months of age at the start of treatment) were more likely to have ototoxicity than were older patients. Children treated with carboplatin should routinely undergo thorough, long-term audiologic monitoring.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Second nonocular tumors in survivors of bilateral retinoblastoma: a possible age effect on radiation-related risk.

              This study aimed to investigate the relationship in bilateral retinoblastoma survivors between the incidence of second tumors and the age when external beam radiation (EBR) was used. A retrospective analysis of patients diagnosed with retinoblastoma was performed by examining records for background information and treatment information as well as reviewing documentation of patients with second nonocular tumors. Two telephone interviews were conducted for follow-up as well as inquiries directed to tumor registries and state databases. The original study included 1729 patients treated in New York and Boston; the current study includes only the 1506 patients treated in New York. Of those, 816 patients were diagnosed with bilateral retinoblastoma, had sufficient treatment data to be useful, and survived at least 1 year from diagnosis. The subjects were observed for evidence of the development of second nonocular tumors. There was a significant decrease in tumor-free survival among patients treated with EBR before the age of 12 months, but no significant difference between the group treated with EBR after the age of 12 months and the group not treated with EBR. For tumors in the field of radiation, patients treated with early EBR showed a significant decrease in tumor-free survival when compared to patients treated with late EBR, with no significant difference between late radiation and no radiation. There were no significant differences between groups for tumors out of the field of radiation. Significant differences attributable to the use of EBR were found only for tumors of the skull and face bones and for tumors of the soft tissue of the head. The long-term effect of radiation treatment on survivors of bilateral retinoblastoma is to increase the incidence and affect the distribution of second tumors. However, no increased risk is observed for tumors out of the field of radiation among patients who underwent radiation, and the risk for tumors in the field of radiation is heavily dependent on the age at which EBR is given and may be acceptably small to the patient after the age of 12 months.
                Bookmark

                Author and article information

                Journal
                24 September 2018
                Article
                10.1118/1.4855855
                1809.09142
                c2f3b810-2f47-424a-96c5-1a98f7febdfc

                http://arxiv.org/licenses/nonexclusive-distrib/1.0/

                History
                Custom metadata
                Medical Physics 41 (2014) 011714
                13 pages, 11 figures, 2 tables
                physics.med-ph

                Medical physics
                Medical physics

                Comments

                Comment on this article