COMPARISON OF DOSES RECEIVED IN THE MANDIBULAR CONDYLE, COCHLEA, AND PAOTID GLAND IN NEUROAXIAL TREATMENT
DOI:
https://doi.org/10.15392/bjrs.v3i2.178Keywords:
dosimetry, radiotherapyAbstract
Sensorineural hearing loss is a common side effect in patients who undergo radiotherapy for the treatment of cancer tumors in the head and neck. In fractioned doses of radiotherapy, in the majority of intracranial tumors, the cochlea is the most affected organ. In addition to the cochlea, the mandible and the parotid glands are also exposed to radiation, which commonly leads to Osteoradionecrosis of the mandible and Xerostomia. In the head and neck regions, this can be complicated by the semi-independence of the positioning in this region, as regards the rigid cranium, connected to the semi-rigid mandible, and successive levels of the upper cervical spine and thoracic spine, which can lead to uncertainty in rotation as well as in head-neck movements, both up and down and side to side. The present study performed an intercomparison of the doses applied through four radiotherapy planning techniques for the neuroaxial regions of the cochlea, mandible, and parotid glands, considering the changes carried out in each planning technique, including the protective shield, the angulations gantry and the field size. The results obtained by applying the half beam and angled field techniques varied in the cochlea by an average of 113.8% from the prescribed dose, whereas when applying the angled field technique with and without the mobile gap, the results varied in 104.5%. In the mandible, the half beam and angled field techniques showed that the dose varied an average of 16.5%, while in the techniques with and without the mobile gap, the variation showed an average of 116.4%. These values were also received by the parotid glands, which overlap the mandible. It can therefore be concluded that the protection shields of the first two techniques were less efficient in protecting the mandible due to its modeling.
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References
ICRP-86. International Commission on Radiological Protection., Prevention of accidental exposures to patients undergoing radiation therapy. Bethesda: ICRP, 2000.
Hua C, Bass J. K., Raja Khan, Kun L. E. and Merchant T. E. “Hearing loss after radiotherapy for pediatric brain tumors effect of cochlear dose”. Int. j. radiation oncology biol. phys., Vol. 72, no. 3, pp. 892–899, 2008.
Paulino A.C., Lobo M, Teh B.S., Okcu M.F., South M., Butler E.B.,Su J., Chintagumpala M. “Ototoxicity after intensity-modulated radiation therapy and cisplatin-based chemotherapy in children with medulloblastoma”. International Journal of Radiation Oncology Biology Physics.Vol. 78, issue 5, Pages 1445-1450, 1 December 2010.
Moeller B. J, Chintagumpala M., Philip J. J, Grosshans D. R, McAleer M. F, Woo S. Y, Gidley P. W, Vats T. S. and Mahajan A. “Low early ototoxicity rates for pediatric medulloblastoma patients treated with próton radiotherapy” Radiation Oncology Vol. 6, pp 51-58, 2011.
Bhandare N., Jackson A., Eisbruch A, Pan C. C., Flickinger J. C., Antonelli P. and Mendenhall W. M.. “Radiation therapy and hearing loss”. Int. J. Radiation Oncology Biol. Phys., Vol. 76, No. 3, Supplement, pp. S50–S57, 2010
Lee I. J., Koom W. S., Lee C. G., Kim Y. B., Yoo S. W., Keum K. C., Kim G. E., Choi E. C. and Cha I. H. Risk factors and dose–effect relationship for mandibular osteoradionecrosis in oral and oropharyngeal cancer patients. Int. j. radiation oncology biol. phys., Vol. 75, no. 4, pp. 1084–1091, 2009.
Gomez D. R.,. Estilo C. L, Wolden S. L.,. Zelefsky M. J., Kraus D. H. Wong, R. J., Shaha A. R., Shah J. P., Mechalakos J. G. and Lee N.Y. “Correlation of osteoradionecrosis and dental events with dosimetric parameters in intensity-modulated radiation therapy for head-and-neck cancer”. Int. J. Radiation Oncology Biol. Phys., Vol. 81, No. 4, pp. e207–e213, 2011.
Meßmer M.-B., Thomsen A, Kirste S., Becke G., Momm F. “Xerostomia after radiotherapy in the head&neck area: Long-term observations”. Radiotherapy and Oncology, Vol. 98, 48–50, 2011.
Wang Z-H., Yan C, Zhang Z-Y., Zhang C-P., Hu H-S., Tu W-Y, Kirwan J. and Mendenhall W. M. “Impact of salivary gland dosimetry on post-imrt recovery of saliva output and xerostomia grade for head-and-neck cancer patients treated with or without contralateral submandibular gland sparing: a longitudinal study”. Int. J. Radiation Oncology Biol. Phys., Vol. 81, No. 5, pp. 1479–1487, 2011.
Ahn P. H., Ahn A. I., Lee C. J., Shen J., Miller E., Lukaj A., Milan E., Yaparpalvi R., Kalnicki S. and Garg M. K.” Random positional variation among the skull, mandible, and cervical spine with treatment progression during head-and-neck radiotherapy”. Int. j. radiation oncology biol. phys., Vol. 73, no. 2, pp. 626–633, 2009.
Sobotta Johannes, “Atlas de anatomia Humana,” 21ed. Rio de Janeiro, Guanabara Koogan, 2000.
Fukunaga-Johnson N., Sandler H.M., Marsh R.,Martel M.K.; “The use 3D conformal radiotherapy (3D CRT) to apare the cochlea in patients with medulloblastoma”. Int.J.Radiat.Oncol.Biol.Phys. Vol. 41,n° 1,pp.77-82,1998.
Hermans R., Fossion E., Ioannides C., Van der Bogaert W., Ghekiere J., Baert A. L.” CT findings in osteoradionecrosis of the mandible”. Skeletal radiol (1996), Vol. 25: 31-36.
Studer G., Grätz K. W., Glanzmann C. “Osteoradionecrosis of the mandíbula in patients treated with different fractionations”. Strahlentherapie und onkologie. Vol. 180: 233-240. 2004.
Jereczek-Fossa B.; Garibaldi C.; Catalano G.; d’ Onofrio A.; DE Pas T.; Bocci C.; Ciocca M.; DE Paoli F.; Orecchia R. “Analisis of mandibular dose distribution in radiotherapy for oropharyngeal cancer: dosimetric and clinical results in 18 patients”; Radiotherapy and Oncology. Vol. 66, pp 49-56, 2003.
Dirix P., Nuyts S., Poorten V.V., Delacre P., Van der Bogaert W. “The influence of xerostomia after radiotherapy on quality of life”. Support care cancer. Vol. 16: 171-179, 2008.
Chambers M.S., Garden A. S., Rosnethal D., Ahamad A., Schwartz D. L., Blanco A. I., Chao K.S. C., Morrison W. H., Ang K.K., Weber R. S. “Intensity-modulated radiotherapy: Is xerostomia still prevalent?”. Current Oncology report. Vol. 7, 131-136, 2005.
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