Acute toxicities after volumetric modulated arc therapy for craniospinal irradiation in adults

Abstract

Objective

Different methodologies to deliver craniospinal irradiation (CSI) to patients have been implemented due to the toxicity and planning challenges associated with traditional three-dimensional conformal radiation therapy. Patient outcomes data are needed to assess the feasibility and safety of these methods.

Methods

We describe the set up and planning methodology used in our clinic to treat adult patients undergoing CSI using volumetric-modulated arc therapy (VMAT). Eight patients treated with CSI using VMAT delivery were reviewed for treatment-associated toxicities and survival.

Results

Median follow-up time was 7.5 months (range 1–44 months), and median radiation dose was 36 Gy (range 23.4–36 Gy). The most common acute toxicities experienced were nausea (n = 5, 62.5%), fatigue (n = 4, 50%), and sore throat (n = 3, 37.5%). Grade III toxicities included leukopenia (n = 2, 25%), fatigue (n = 1, 12.5%), anemia (n = 1, 12.5%), and nausea (n = 1, 12.5%). There were no grade IV or V toxicities. Only patients receiving adjuvant chemotherapy (n = 2) had hematologic toxicities (grade II anemia, n = 1; grade III anemia n = 1; grade III leukopenia, n = 2).

Conclusions

VMAT radiation delivery is feasible and well tolerated in adult patients receiving CSI. The addition of adjuvant chemotherapy carries an increased risk for hematologic toxicity.

https://ift.tt/2K4MiZj