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KMID : 0387820100170010043
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Clinical Pediatric Hematology-Oncology
2010 Volume.17 No. 1 p.43 ~ p.50
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Clinical Significance of Helical Tomotherapy in Children with Extracranial Disease
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Yoo Hyo-Joo
Bae E-Young
Chung Nack-Gyun
Cho Bin
Kim Ji-Yoon
Kay Chul-Seung
Lee Ji-Won
Kang Hyoung-Jin
Shin Hee-Young
Ahn Hyo-Seop
Kim Hack-Ki
Jeong Chang-Mo
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Abstract
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Purpose: Radiation therapy (RT) is one of the most important treatment options in pediatric oncology. Conventional RT is effective in short term tumor control, but may cause normal tissue or organ damage, acute toxicities or late toxicities. Helical tomotherapy as an image-guided IMRT (intensity-modulated RT) can provide homogeneous dose distribution within the target region by conformal images. We evaluated the effect of tomotherapy and acute toxicities during tomotherapy in children with extracranial tumors.
Methods: We retrospectively reviewed medical records of children who received tomotherapy between January, 2007 and August, 2009 in Incheon St. Mary’s hospital, The Catholic University of Korea. We investigated patients’ diagnosis and disease status, objectives of tomotherapy, radiation dose and field, organ at risk, and survival.
Results: Seven children with extracranial malignancies experienced nine tomotherapies. One of them received tomotherapy for curative treatment, the others for palliation with disease control. Three children died due to disease progression after tomotherapy. Two children experienced grade II leukopenia with thrombocytopenia, and one boy experienced transient grade II xerostomia with controlled permanent hypothyroidism.
Conclusion: elical tomotherapy is a very effective treatment modality in the pediatric field without causing serious acute toxicities. Helical tomotherapy can be applied to a complicated anatomical site, recurrent tumor site, multiple metastasis, while sparing normal organs or tissues. Further prospective clinical trials and close follow-up will be needed to prove the long-term effects of helical tomotherapy.
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KEYWORD
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Radiation therapy, Pediatric tumor, Toxicity, Helical tomotherapy
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