Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-25T11:49:49.360Z Has data issue: false hasContentIssue false
  • English
  • Français

Estimation of the risk of secondary malignancies following intraoral electron radiotherapy for tongue cancer patients

Published online by Cambridge University Press:  28 November 2016

Seonghoon Jeong ,
Myonggeun Yoon ,
Weon Kuu Chung ,
Mijoo Chung  and
Dong Wook Kim
Seonghoon Jeong
Affiliation:
Department of Bio-Convergence Engineering, Korea University, Seoul, Korea
Myonggeun Yoon
Affiliation:
Department of Bio-Convergence Engineering, Korea University, Seoul, Korea
Weon Kuu Chung*
Affiliation:
Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
Mijoo Chung
Affiliation:
Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
Dong Wook Kim
Affiliation:
Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
*
Correspondence to: Weon Kuu Chung, Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Dongnam-ro 892, Gangdong-Gu, Seoul 134-727, Korea. Tel: +82 2 440 7398. Fax: +82 2 440 7393. E-mail: wkchung@khnmc.or.kr, joocheck@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Purpose

To measure dosimetric characteristics for linear accelerator-based electron beams, which are applied through locally manufactured acrylic tubes for intraoral radiotherapy and to calculate the secondary cancer risk for organs at risk.

Materials and methods

Six different acrylic tubes were exposed to a 6-MeV electron beam; they had tips with three angles (0°, 15° and 30°) and two diameters (2·5 and 3·0 cm). Gafchromic EBT2 film was horizontally and vertically inserted in a solid water phantom to measure the dose profiles and percentage depth doses (PDDs). The measured data from radio-photoluminescence glass dosimeters placed on the neck and both eyes were used to estimate the lifetime attributable risk of secondary cancer resulting from intraoral radiotherapy for tongue cancer.

Results

A total of 12 dose profiles were obtained from six different acrylic applicators at 0·5 and 1·28 cm depths. Circular shapes were obtained from 0° applicators, and oval shapes were obtained from 15° and 30° applicators. Absorbed doses at a 0·5 cm depth were higher than those at a 1·28 cm depth. PDD shapes for the six acrylic applicators were similar to those of a normal 6 MeV electron beam. Larger-diameter applicators showed higher PDD than smaller-diameter applicators with the same tip angle. According to our secondary cancer risk estimation, if 100,000 patients received intraoral radiotherapy at 30 years and lived until 80 years, 122 female and 22 male patients would develop secondary thyroid cancer, while 13 female and 18 male patients would develop secondary ocular melanoma or retinoblastoma.

Conclusions

Dosimetric characteristics for linear accelerator-based intraoperative radiotherapy treatment beam were confirmed. In addition, we found that 0·1% of tongue cancer patients would get secondary malignancies for both eyes and thyroid from this treatment.

Keywords

doseelectron radiotherapyintraoral cone radiotherapyradio-photoluminescence glass dosimetersecondary cancer risk
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 16 , Issue 1 , March 2017 , pp. 46 - 52
Check for updates
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

Weon Kuu Chung and Dong Wook Kim equally contributed as corresponding authors.

References

1. Abe, M, Takahashi, M. Intraoperative radiotherapy: the Japanese experience. Int J Radiat Biol Phys 1981; 7: 863–868.CrossRefGoogle ScholarPubMed
2. Nemoto, K, Ogawa, Y, Matsushita, H et al. Intraoperative radiation therapy (IORT) for previously untreated malignant gliomas. BMC Cancer 2002; 2: 1.Google Scholar
3. Zachario, Z, Sieverts, H, Eble, M J, Gfrorer, S, Zavitzanakis, A. IORT (intraoperative radiotherapy) in neuroblastoma: experience and first results. Pediatr Surg 2002; 12: 251–254.Google Scholar
4. Fletcher, G H, Shukovsky, L J. The interplay of radiocurability and tolerance in the irradiation of human cancers. J Radiol Electrol 1975; 56: 383–400.Google Scholar
5. Fletcher, G H. Clinical dose response curves of human malignant epithelial tumors. Br J Radiol 1973; 46: 1–12.Google Scholar
6. Valentini, V, Morganti, A G, De Franco, A et al. Chemoradiation with or without intraoperative radiation therapy in patients with locally recurrent rectal carcinoma: prognostic factors and long-term outcome. Cancer 1999; 86: 2612–2624.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
7. Kim, H K, Kum, O. Development of a parallel electron and photon transport (PMCEPT) code II: absorbed dose computation in homogeneous and heterogeneous media. J Korean Phys Soc 2006; 49: 1640–1651.Google Scholar
8. American Association of Physicists in Medicine Task Group 71. A protocol for the determination of absorbed dose from high-energy photon and electron beams. Med Phys 1983; 10: 741–771.Google Scholar
9. International Atomic Energy Agency. Absorbed Dose Determination in External Beam Radiotherapy: An International Code of Practice for Dosimetry Based on Standards of Absorbed Dose to Water. Technical Series No. 398. Vienna: IAEA 2000.Google Scholar
10. Chung, J B, Lee, J W, Suh, T S et al. Dosimetric characteristics of standard and micro MOSFET dosimeters as in-vivo dosimeter for clinical electron beam. J Korean Phys Soc 2009; 55: 2566–2570.Google Scholar
11. Anderson, L L, Harington, P J, St Germain, J. Physics of intraoperative high-dose-rate brachytherapy. In: Gunderson L L, Willet C G, Harrison L B, Calvo F A (eds). Intraoperative Irradiation: Techniques and Results. Totowa, NJ: Humana Press, 2000: 87–104.Google Scholar
12. Biggs, P J, Epp, E R, Ling, C C, Novack, D H, Michaels, H B. Dosimetry, field shaping and other considerations for intra-operative electron therapy. Int J Radiat Biol Phys 1981; 7: 875–884.Google Scholar
13. Chu, S S, Kim, G E, Loh, J L. Design and dose distribution of docking applicator for an intraoperative radiation therapy. Korean Soc Ther Radiol 1991; 9 (1): 123–130.Google Scholar
14. American Association of Physicists in Medicine Task Group 72. Intraoperative radiation therapy using mobile electron linear accelerators. Med Phys 2006; 33: 1476–1509.Google Scholar
15. Piriz, G H, Lozano, E, Banguero, Y et al. Implementation of intraoperative radiotherapy in a linear accelerator VARIAN 21EX. Rev Bras Fis Med 2001; 5: 31–34.Google Scholar
16. Piesch, E, Burgkhardt, B, Vilgis, M. Photoluminescence dosimetry: process and present state of art. Radiat Prot Dosim 1990; 33: 215–225.Google Scholar
17. Asahi Techno Glass Corporation. RPL Glass Dosimeter/Small Element System: Dose Ace. Tokyo: Asahi Techno Glass, 2000.Google Scholar
18. Hus, S M, Yeh, S H, Lin, M S, Chen, W L. Comparison on characteristics of radiophotoluminescent glass dosimeters and thermoluminescent dosimeters. Radiat Prot Dosim 2006; 119: 327–331.Google Scholar
19. Araki, F, Moribe, N, Shimonobou, T, Yamashita, Y. Dosimetric properties of radiophotoluminescent glass rod detector in high-energy photon beams from a linear accelerator and cyber-knife. Med Phys 2004; 31: 1980–1986.CrossRefGoogle Scholar
20. International Commission on Radiation Units and Measurements. Prescribing, recording, and reporting electron beam therapy. J ICRU 2004; 4: 5–9.Google Scholar
21. Chung, W K, Kim, D W. Characteristic study of a radiophotoluminescence radio-photoluminescence glass rod detector for clinical usages: skin and inner body in-vivo verification. J Korean Phys Soc 2013; 62: 670–676.Google Scholar
22. Bijan, A, Remesh, T, Aman, A et al. Energy dependence and dose response of Gafchromic EBT2 film over a wide range of photon, electron, and proton beam energies. Med Phys 2010; 37: 1942–1965.Google Scholar
23. Bernadette, H, Maria, M, Oliver, J. Technical note: homogeneity of Gafchromic EBT2 film. Med Phys 2010; 37: 1753–1825.Google Scholar
24. Schneider, U, Kaser-Hotz, B. A simple dose-response relationship for modeling secondary cancer incidence after radiotherapy. Med Phys 2005; 15: 31–37.Google ScholarPubMed
25. Schneider, U, Zwahlen, D, Ross, D, Kaser-Hotz, B. Estimation of radiation-induced cancer from three-dimensional dose distributions: concept of organ equivalent dose. Int J Radiat Biol Phys 2005; 61: 1510–1515.Google Scholar