Lefebvre L, Doyeux K, Linca S, Challand T, Hanzen C
Département de radiothérapie, centre Henri-Becquerel, rue d'Amiens, 76038 Rouen cedex 1, France.
Département de radiothérapie, centre Henri-Becquerel, rue d'Amiens, 76038 Rouen cedex 1, France.
Cancer Radiother. 2014 Dec;18(8):763-6. doi: 10.1016/j.canrad.2014.07.158. Epub 2014 Oct 30.
The purpose was to assess three treatments planning techniques including one in intensity-modulated radiation therapy (IMRT) for cerebral irradiation of pregnant woman, in order to limit the dose delivered to the foetus. The treatment provided was 60 Gy to the planning target volume. Estimated foetal dose was measured using an anthropomorphic phantom, on the upper and middle part of the uterus. The first plan consisted in four beams in conformational technique delivered from a Varian accelerator with a 120 leaves collimator, the second one used non-coplanar fields and the third one assessed IMRT. With the conformational technique, the dose at the upper part of the uterus was 8.3 mGy and 6.3 mGy at the middle part. The dose delivered to the foetus was higher with the non-coplanar fields. In IMRT, the dose at the upper part of the uterus was 23.8 mGy and 14.3 mGy at the middle part. The three plans used 6 MV X-rays. Because of the use of leaves and non-coplanar fields, IMRT does not seem to be the optimal technique for the treatment of pregnant woman. However, the dose delivered to the foetus remains low and below the dose of 100 mGy recommended by the International Commission of Radiological Protection. It seems possible to consider the use of this technique for a better sparing of organs at risk for the mother.
目的是评估三种治疗计划技术，其中包括一种用于孕妇脑部放疗的调强放射治疗（IMRT）技术，以限制传递给胎儿的剂量。给予计划靶体积的治疗剂量为60 Gy。使用人体模型在子宫的上部和中部测量估计的胎儿剂量。第一个计划采用Varian加速器配备120叶准直器以适形技术进行四野照射，第二个计划使用非共面野，第三个计划评估IMRT。采用适形技术时，子宫上部的剂量为8.3 mGy，中部为6.3 mGy。非共面野传递给胎儿的剂量更高。在IMRT中，子宫上部的剂量为23.8 mGy，中部为14.3 mGy。这三个计划均使用6 MV X射线。由于使用了叶片和非共面野，IMRT似乎不是治疗孕妇的最佳技术。然而，传递给胎儿的剂量仍然很低，低于国际放射防护委员会推荐的100 mGy剂量。似乎可以考虑使用这种技术更好地保护母亲的危险器官。
