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• W2095535247 abstract "Technological advances have markedly improved conformal delivery of radiation therapy. Acute treatment-related adverse effects are reduced; however, the impact of second malignancy risk due to low dose irradiation of normal tissues is unknown. This study was designed to estimate the risk of radiation-induced tumors following treatment of pituitary adenoma. A standard case of a patient with a pituitary adenoma with indication for fractionated radiation therapy was planned using 6 different dosimetric techniques: (1) 2-field conformal photon plan, (2) 3-field conformal photon plan, (3) 5-field intensity-modulated radiotherapy with photons (IMRT), (4) stereotactic radiotherapy with photons using 4 arcs (SRT), (5) 2-field conformal proton plan, and (6) 3-field conformal proton plan. Total dose was 50.4 GyE at daily fractionation of 1.8 GyE. All methods utilized the same CT simulation scan with designated target and normal tissue volumes. The excess risk of radiation-induced second tumors in the brain was calculated using the corresponding dose-volume histograms for the whole brain and based on the data published by the United Nation Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) and a risk model proposed by Schneider. The excess risks of radiation-induced second tumors in the volume of the whole brain per 10,000 patients per year are: 2-field photon 4.7, 3-field photon 9.6, IMRT 29.5, SRT 32.1, 2-field protons 1.6, and 3-field protons 11.1. Two-field techniques had the lowest risk for second tumors but were also less conformal and delivered greater excess dose to the temporal lobes. Increasing conformality of dose distribution by using multiple fields is achieved at the trade off of increased dose to the normal brain and of increased risk of radiation-induced tumors. Limiting the irradiated volume of normal brain by reducing the number of treatment fields is desirable to minimize excess risk of radiation-induced second tumors." @default.
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• W2095535247 date "2007-11-01" @default.
• W2095535247 modified "2023-10-14" @default.
• W2095535247 title "Second Tumor Risk With Modern Radiotherapy for Pituitary Adenomas" @default.
• W2095535247 doi "https://doi.org/10.1016/j.ijrobp.2007.07.2078" @default.
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