Case Report: Anaplastic Astrocytoma Treated with Postoperative Radiotherapy Using Flattening Filter-Free Volumetric Arc Therapy (FFF-VMAT) during Pregnancy—Acceptable Fetal Dosimetry

• 作者: Hideomi Yamashita Kanabu Nawa Keiichi Nakagawa Osamu Abe Tomoyuki Noyama Wataru Takahashi Yuki Nozawa
• 来源期刊: 癌症治疗(英文)
• 学科: 医学
• 关键词: PREGNANCY Radiotherapy Flattening Filter-Free Volumetric Arc Therapy An-aplastic Astrocytoma Fetal Dose
• 年，卷（期）: azzlyw_2020,（11）
• 页码范围: 738-744
• 页数: 7页
• 分类号: R73

摘要

<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Postoperative irradiation for brain tumor in pregnant women is a matter of concern. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> We aimed to assess the safety of radiotherapy for brain tumors in pregnancy. We here report a successful treatment for anaplastic astrocytoma during pregnancy: surgery + postoperative irradiation. We wish to emphasize how we devised irradiation procedure to achieve both therapeutic effectiveness and safety to the fetus/infant. </span><b><span style="font-family:Verdana;">Case Presentation: </span></b><span style="font-family:Verdana;">A 34-year-old pregnant woman suffered with brain anaplastic astrocytoma. Tumor resection under craniotomy was performed with success. We decided to conduct postoperative radiotherapy at 25 weeks of gestation to reduce the risk of recurrence. We used a flattening filter-free volumetric arc therapy (FFF-VMAT) technique, which can achieve lower out-of-field dose than VMAT with a flattening filter or helical tomotherapy. We prescribed 60 Gy over 30 fractions. During actual beam delivery, surface and rectal dose to the patient (mother) were measured. The total fetal dose was estimated at 0.006 - 0.018 Gy, which is under the threshold set by the ICRP. A male healthy infant was born vaginally at the 37th week of pregnancy. The patient (mother) and the infant are healthy at the time of writing.</span><b><span style="font-family:Verdana;"> Conclusion: </span></b><span style="font-family:Verdana;">FFF-VMAT is a good choice for brain tumors during pregnancy</span></span></span></span><span style="font-family:Verdana;">.</span>