Medical Physics Department, La Paz University Hospital, Madrid, Spain.
Neuroradiology Department, La Paz University Hospital, Madrid, Spain.
Sci Rep. 2019 Dec 27;9(1):20113. doi: 10.1038/s41598-019-56623-4.
Retinoblastoma represents 3% of cancers in children under fifteen years of age. The standard paediatric treatment for saving the affected eye is supraselective intra-arterial chemotherapy performed in interventional rooms. In order to address the radiation toxicity due to the angiography, the aim of this study was to determine the typical dose value corresponding to the procedure, estimate the paediatric patients' eye lens dose and study the relationship between dose indicators and dose to the lens. An automatic dose management software was installed in two interventional rooms to obtain the distribution of the dose indicators kerma-area product and reference-point air kerma, getting a typical value 16 Gy·cm and 130 mGy, respectively (n = 35). The eye lens dose estimates were obtained with photoluminescent dosimeters placed on the patient's eyelids. In the left eye, the entrance surface air kerma was 44.23 ± 2.66 mGy, and 12.72 ± 0.89 mGy in the right eye (n = 10). There was a positive correlation between dose to the lens per procedure and dose indicators, with R > 0.65 for both eyes. Based on this information, the threshold for the onset of radiation-induce cataracts (500 mGy) will be exceeded if the treatment is performed for more than 8 sessions.
视网膜母细胞瘤占 15 岁以下儿童癌症的 3%。挽救患眼的标准儿科治疗方法是在介入室进行超选择性动脉内化疗。为了解决血管造影的辐射毒性问题,本研究旨在确定与该手术相关的典型剂量值,估算儿童患者的晶状体剂量,并研究剂量指标与晶状体剂量之间的关系。在两个介入室中安装了自动剂量管理软件,以获取剂量指标比释动能面积乘积和参考点空气比释动能的分布,得到典型值分别为 16Gy·cm 和 130mGy(n=35)。通过在患者眼睑上放置光致发光剂量计来估算晶状体剂量。左眼的入射表面空气比释动能为 44.23±2.66mGy,右眼为 12.72±0.89mGy(n=10)。每例手术晶状体剂量与剂量指标之间呈正相关,双眼的相关系数均大于 0.65。基于这些信息,如果治疗超过 8 次,将会超过引发白内障的辐射剂量阈值(500mGy)。