Takahashi, Wataru The University of Tokyo
Nawa, Kanabu The University of Tokyo
Yamashita, Hideomi The University of Tokyo
Imae, Toshikazu The University of Tokyo
Ogita, Mami The University of Tokyo
Okuma, Kae The University of Tokyo
Abe, Osamu The University of Tokyo
Nakagawa, Keiichi The University of Tokyo
Intensity-modulated radiation therapy
Optimizing irradiation protocols for pregnant women is challenging, because there are few cases and a dearth of fetal dosimetry data. We cared for a 36-year-old pregnant woman with tongue cancer. Prior to treatment, we compared three intensity-modulated radiation therapy (IMRT) techniques, including helical tomotherapy, volumetric arc therapy (VMAT), and flattening-filter free VMAT (FFF-VMAT) using treatment planning software. FFF-VMAT achieved the minimum fetal exposure and was selected as the optimal modality. We prescribed 66 Gy to the involved nodes, 60 Gy to the tumor bed and ipsilateral neck, and 54 Gy to the contralateral neck over 33 fractions. To confirm the out-of-field exposure per fraction, surface doses and the rectal dose were measured during FFF-VMAT delivery. Postoperative chemoradiotherapy was delivered using IMRT and a cisplatin regimen. Without any shielding, the total fetal dose was 0.03 Gy, within the limits established by the ICRP. A healthy girl was born vaginally at 37 weeks’ gestation.
Clinical and Translational Radiation Oncology
European Society for Radiotherapy and Oncology|Elsevier
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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