PURPOSE: To compare the numerous external radiotherapy (RT) techniques for the treatment of retinoblastoma, as well as an intensity-modulated RT (IMRT) technique. The latter was elaborated to evaluate the potential dose reduction in the surrounding tissue, as well as the potential avoidance of subdosage in the ora serrata retinae. METHODS AND MATERIALS: A 2-year-old patient with unilateral retinoblastoma underwent CT. With the aid of an ophthalmologist, the ocular structures were delimited, and 13 techniques described in published reports were reproduced on three-dimensional planning software and identified according to their authors. A technique with four noncoplanar fields using IMRT was also elaborated. These techniques were compared according to the dose to the ora serrata retinae, lens, orbit (volume that received a dose of >or=20 Gy), vitreous, optic nerve, lacrimal gland (volume that received a dose of >or=34 Gy), and cornea and according to their ease of reproducibility. RESULTS: The techniques that attained the therapeutic dose to the ora serrata retinae were the IMRT technique and the techniques of Haye, Cassady, Cormack, and al-Beteri. The Cormack technique had the lowest volume that received a dose of >or=20 Gy in the orbit, followed by the IMRT technique. The IMRT technique also achieved the lowest volume that received a dose of >or=34 Gy (14%) in the lacrimal gland. The Abramson/McCormick/Blach, Cassady, Reese, and Schipper techniques were the easiest to reproduce and the Chin the most complex. CONCLUSION: Retinoblastoma treatment with IMRT has an advantage over the other techniques, because it allows for the greatest reduction of dose to the orbit and lacrimal gland, while maintaining the therapeutic dose to the ora serrata retinae and vitreous.
PURPOSE: To compare the numerous external radiotherapy (RT) techniques for the treatment of retinoblastoma, as well as an intensity-modulated RT (IMRT) technique. The latter was elaborated to evaluate the potential dose reduction in the surrounding tissue, as well as the potential avoidance of subdosage in the ora serrata retinae. METHODS AND MATERIALS: A 2-year-old patient with unilateral retinoblastoma underwent CT. With the aid of an ophthalmologist, the ocular structures were delimited, and 13 techniques described in published reports were reproduced on three-dimensional planning software and identified according to their authors. A technique with four noncoplanar fields using IMRT was also elaborated. These techniques were compared according to the dose to the ora serrata retinae, lens, orbit (volume that received a dose of >or=20 Gy), vitreous, optic nerve, lacrimal gland (volume that received a dose of >or=34 Gy), and cornea and according to their ease of reproducibility. RESULTS: The techniques that attained the therapeutic dose to the ora serrata retinae were the IMRT technique and the techniques of Haye, Cassady, Cormack, and al-Beteri. The Cormack technique had the lowest volume that received a dose of >or=20 Gy in the orbit, followed by the IMRT technique. The IMRT technique also achieved the lowest volume that received a dose of >or=34 Gy (14%) in the lacrimal gland. The Abramson/McCormick/Blach, Cassady, Reese, and Schipper techniques were the easiest to reproduce and the Chin the most complex. CONCLUSION:Retinoblastoma treatment with IMRT has an advantage over the other techniques, because it allows for the greatest reduction of dose to the orbit and lacrimal gland, while maintaining the therapeutic dose to the ora serrata retinae and vitreous.
Authors: Steven M Nguyen; Julian Sison; Marjorie Jones; Jesse L Berry; Jonathan W Kim; A Linn Murphree; Vanessa Salinas; Arthur J Olch; Eric L Chang; Kenneth K Wong Journal: Int J Radiat Oncol Biol Phys Date: 2018-12-08 Impact factor: 7.038
Authors: Kent W Mouw; Beow Y Yeap; Paul Caruso; Aaron Fay; Madhusmita Misra; Roshan V Sethi; Shannon M MacDonald; Yen-Lin Chen; Nancy J Tarbell; Torunn I Yock; Suzanne K Freitag; John E Munzenrider; Eric Grabowski; Michelle Katz; Karen Kuhlthau; Dawn DeCastro; Gena Heidary; Jessica Ciralsky; Shizuo Mukai; Helen A Shih Journal: Adv Radiat Oncol Date: 2017 Jan-Mar