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Novel Technique of Craniospinal Axis Proton Therapy with the Spot-Scanning System : Avoidance of Patching Multiple Fields and Optimized Ventral Dose Distribution = Innovative Technik zur Behandlung der kraniospinalen Achse mit Spot-Scanning-Protonentherapie. Vermeidung von Feldanschlüssen und Optimierung der ventralen Dosisverteilung

Timmermann, Beate ; Lomax, Antony ; Nobile, Luisa ; Grotzer, Michael ; Weiss, Markus ; Kortmann, Rolf-Dieter ; Bolsi, Alessandra ; Goitein, Gudrun

In: Strahlentherapie und Onkologie, 2007, vol. 183, no. 12, p. 685-688

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    Title
    • Novel Technique of Craniospinal Axis Proton Therapy with the Spot-Scanning System
      Avoidance of Patching Multiple Fields and Optimized Ventral Dose Distribution
    Translated Title ()
    • Innovative Technik zur Behandlung der kraniospinalen Achse mit Spot-Scanning-Protonentherapie. Vermeidung von Feldanschlüssen und Optimierung der ventralen Dosisverteilung
    Author
    • Timmermann, Beate. Center for Proton Radiation Therapy, Paul Scherrer Institute, Villigen, Switzerland
    • Lomax, Antony. Center for Proton Radiation Therapy, Paul Scherrer Institute, Villigen, Switzerland
    • Nobile, Luisa. Children's Hospital, Hospital Locarno, Switzerland
    • Grotzer, Michael. University Children's Hospital of Zurich, Switzerland
    • Weiss, Markus. University Children's Hospital of Zurich, Switzerland
    • Kortmann, Rolf-Dieter. Department of Radiation Oncology, University of Leipzig, Germany
    • Bolsi, Alessandra. Center for Proton Radiation Therapy, Paul Scherrer Institute, Villigen, Switzerland
    • Goitein, Gudrun. Center for Proton Radiation Therapy, Paul Scherrer Institute, Villigen, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:316726
    Summary
    Background and Purpose:: Conventional craniospinal irradiation (CSI) is a complex procedure carrying a high risk of adverse side effects. Still, it is indispensable for cure in a number of pediatric brain tumors. In this study, the feasibility and the potential advantage of spot-scanning proton therapy for CSI are investigated. Material and Methods:: A boy (5.5 years of age) with a recurrent medulloblastoma received CSI with a single posterior field using the spot-scanning system at Paul Scherrer Institute. Dose distribution to the targets and the organs at risk, treatment time, reproducibility of patient positioning, toxicity (according to EORTC/RTOG score), and treatment outcome were evaluated. Results:: The plan achieved a homogeneous coverage of the target volume, even using a single field. The doses to the organs ventral to the target were minimized. During treatment, grade 1 skin reaction and grade 2 central nervous system toxicity were observed. After 2 months, the boy presented with a transitory fatigue. After 24 months, he is alive and free of disease. Growth hormones and thyroid hormones are reduced. Conclusion:: These results, based on a single patient, suggest that spot-scanning proton therapy for craniospinal treatment is feasible and safe. By applying a single dorsal field, difficulties of multiple-field patching can be avoided and the ventral dose spread can be minimized