How should dose homogeneity across bone be handled in pediatric patients?
To minimize the likelihood of asymmetrical growth, when is it of sufficient concern to necessitate altering planning objects?
When planning paediatric lymphoma case, how would you manage dose inhomogeneity in the spine?
Do you look for any specific isodose line that should cover entire spine?
What ages are relevant for this consideration?
i.e. Are pediatric Hodgkin patients at risk?
Are there studies which can help determine extent of epiphyseal closure and bone age?
What is the dose threshold for consideration of mitigating non-uniform doses across bone/vertebrae?
Is there a trade-off between increased integral dose to minimize growth asymmetry and increased risk for second cancers?
2 Answers
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Radiation Oncology · University of Nebraska Medical Center
Answered on
The radiation-associated bone damage can be affected by many factors, including total radiation dose, fractionation schedule, treatment volume, age of the child, symmetry of the delivered dose over vertebrae, developmental status of the irradiated growth plates, treatments such as chemotherapy or su...
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Radiation Oncology · Texas Center for Proton Therapy
Answered on · Updated on
To minimize the likelihood of asymmetrical growth, when is it of sufficient concern to necessitate altering planning objectives?
What ages are relevant for this consideration?
The SIOPE Radiotherapy working group recently published consensus recommendations for management of vertebral radiotherapy dos...
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