DOSIMETRIC COMPARISON OF SCALP AND ORGANS AT RISK WITH DIFFERENT RADIOTHERAPY TECHNIQUES IN MALIGN GLIAL TUMORS

Öz

In malign glial tumors treated with radiotherapy (RT); despite the current treatment plan with volumetric arc (t-VMAT) technique, 1 arc VMAT and static 5 field intensity modulated RT technique wre compered dosimetrically. Sixteen malign glial tumors treated with at least 50 Gy RT were included. Sixteen, 30 and 24 Gray thresholds doses were used for mean, 1 and 9 cc scalp volumes. There was no statistically significant difference between methods in terms of planning treatment volume and risky organ doses. Significant reductions in scalp doses were observed (p < 0.05) with the inclusion of scalp regardless of the planning methods. Despite the hair loss in acute period, there was no permanent hair loss in any case in 12-month follow-up. It has been shown by this study, the inclusion of scalp into the treatment plan does not have a negative effect on the target volume doses, and our patients may be protected from cosmetic and psychosocial side effects caused by permanent hair loss.

Anahtar Kelimeler

• Malign glial tumor,radiotherapy techniques,scalp,hair-sparing treatment,dosimetry

Malign Glial Tümörlerde Farklı Radyoterapi Teknikleri ile Saçlı Deri ve Riskli Organların Dozimetrik Karşılaştırılması

Öz

Volumetrik ark (t-VMAT) tekniği ile radyoterapi (RT) uygulanan malign glial tümörlü hastalarda mevcut tedavi planına karşın 1 ark VMAT ve statik 5 alan yoğunluk ayarlı RT tekniği dozimetrik olarak karşılaştırıldı. Çalışmaya en az 50 Gy RT alan 18 malign glial tümörlü olgu dahil edildi. Saçlı deri ortalama, 1 ve 9 cc dozları için 16, 30 ve 24 Gray eşik değerleri kullanıldı. Yöntemler arasında planlama tedavi volümü ve riskli organ dozları açısından anlamlı fark bulunamadı. Planlamanın hangi yöntem ile yapıldığı önemli olmaksızın saçlı derinin planlamaya dahil edilmesiyle birlikte saçlı deri dozlarının anlamlı azaldığı görüldü (p < 0.05). Oniki aylık izlem süresi içinde akut dönemde saç kaybı yaşamalarına rağmen hiçbir olguda kalıcı saç kaybı görülmedi. Bu çalışma ile saçlı derinin tedavi planına dahil edilmesinin hedef volüm dozları açısından olumsuz etkisi olmadığı gibi hastalarımızın kalıcı saç dökülmesinin yaratacağı kozmetik ve psikososyal yan etkilerden korunabileceği ortaya konulmuştur. 

Anahtar Kelimeler

• malign glial tümör,radyoterapi tekniği,saçlı deri,saç koruyucu tedavi,dozimetri

Kaynakça

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