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Radiation treatment planning and delivery strategies for a pregnant brain tumor patient

Overview of attention for article published in Journal of Applied Clinical Medical Physics, July 2018
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Title
Radiation treatment planning and delivery strategies for a pregnant brain tumor patient
Published in
Journal of Applied Clinical Medical Physics, July 2018
DOI 10.1002/acm2.12262
Pubmed ID
Authors

Zacariah E. Labby, Brendan Barraclough, R. Adam Bayliss, Abigail E. Besemer, David A. P. Dunkerley, Steven P. Howard

Abstract

The management of a pregnant patient in radiation oncology is an infrequent event requiring careful consideration by both the physician and physicist. The aim of this manuscript was to highlight treatment planning techniques and detail measurements of fetal dose for a pregnant patient recently requiring treatment for a brain cancer. A 27-year-old woman was treated during gestational weeks 19-25 for a resected grade 3 astrocytoma to 50.4 Gy in 28 fractions, followed by an additional 9 Gy boost in five fractions. Four potential plans were developed for the patient: a 6 MV 3D-conformal treatment plan with enhanced dynamic wedges, a 6 MV step-and-shoot (SnS) intensity-modulated radiation therapy (IMRT) plan, an unflattened 6 MV SnS IMRT plan, and an Accuray TomoTherapy HDA helical IMRT treatment plan. All treatment plans used strategies to reduce peripheral dose. Fetal dose was estimated for each treatment plan using available literature references, and measurements were made using thermoluminescent dosimeters (TLDs) and an ionization chamber with an anthropomorphic phantom. TLD measurements from a full-course radiation delivery ranged from 1.0 to 1.6 cGy for the 3D-conformal treatment plan, from 1.0 to 1.5 cGy for the 6 MV SnS IMRT plan, from 0.6 to 1.0 cGy for the unflattened 6 MV SnS IMRT plan, and from 1.9 to 2.6 cGy for the TomoTherapy treatment plan. The unflattened 6 MV SnS IMRT treatment plan was selected for treatment for this particular patient, though the fetal doses from all treatment plans were deemed acceptable. The cumulative dose to the patient's unshielded fetus is estimated to be 1.0 cGy at most. The planning technique and distance between the treatment target and fetus both contributed to this relatively low fetal dose. Relevant treatment planning strategies and treatment delivery considerations are discussed to aid radiation oncologists and medical physicists in the management of pregnant patients.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 11 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 11 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 3 27%
Other 2 18%
Student > Master 2 18%
Student > Ph. D. Student 1 9%
Researcher 1 9%
Other 0 0%
Unknown 2 18%
Readers by discipline Count As %
Medicine and Dentistry 4 36%
Physics and Astronomy 3 27%
Neuroscience 1 9%
Nursing and Health Professions 1 9%
Unknown 2 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 August 2018.
All research outputs
#11,815,545
of 13,316,854 outputs
Outputs from Journal of Applied Clinical Medical Physics
#593
of 792 outputs
Outputs of similar age
#232,463
of 268,683 outputs
Outputs of similar age from Journal of Applied Clinical Medical Physics
#20
of 33 outputs
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So far Altmetric has tracked 792 research outputs from this source. They receive a mean Attention Score of 1.6. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 268,683 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.