The aim of this treatment planning comparison study was to explore different spinal irradiation techniques with respect to the risk of late side-effects, particularly radiation-induced @entity5 . The radiotherapy techniques compared were conventional photon therapy, @entity13671 ( @entity13671 ), conventional electron therapy, intensity/energy modulated electron therapy (IMET) and proton therapy (IMPT).CT images for radiotherapy use from five @entity1 , median age 8 and diagnosed with @entity2946 , were selected for this study. Target volumes and organs at risk were defined in 3-D. Treatment plans using conventional photon therapy, @entity13671 , conventional electron therapy, IMET and IMPT were set up. The probability of normal tissue complication (NTCP) and the risk of @entity5 were calculated using models with parameters-sets taken from published data for the general population; dose data were taken from dose volume histograms (DVH). Similar dose distributions in the targets were achieved with all techniques but the absorbed doses in the organs-at-risk varied significantly between the different techniques. The NTCP models based on available data predicted very low probabilities for side-effects in all cases. However, the effective mean doses outside the target volumes, and thus the predicted risk of @entity5 , varied significantly between the techniques. The highest lifetime risk of secondary @entity5 was estimated for @entity13671 (30%). The lowest risk was found with IMPT (4%). The risks associated with conventional photon therapy, electron therapy and IMET were 20%, 21% and 15%, respectively. This model study shows that spinal irradiation of young @entity1 with photon and electron techniques results in a substantial risk of radiation-induced secondary @entity5 . Multiple beam @entity13671 seems to be associated with a particularly high risk of secondary @entity5 . To minimise this risk, IMPT should be the treatment of choice. If proton therapy is not available, advanced electron therapy may provide a better alternative.

Does electron and proton therapy reduce the risk of radiation induced cancer after spinal irradiation for XXXX ? A comparative treatment planning study.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancers', 'cancer induction', 'cancer'] @entity1 :: ('9606', 'Species') :: ['children'] @entity13671 :: ('MESH:C562844', 'Disease') :: ['intensity modulated x-ray therapy', 'IMXT'] @entity2946 :: ('MESH:D008527', 'Disease') :: ['medulloblastoma']
@entity2946 :: (MESH:D008527,Disease) :: ['childhood medulloblastoma']
