Postoperative radiotherapy for synovial sarcoma of the head and neck during pregnancy: Clinical and technical management and fetal dose estimates

Ester Orlandi, Giancarlo Zonca, Emanuele Pignoli, Claudio Stucchi, Marta Borroni, Paola Collini, Giulio Cantù, Paolo G. Casali, Federica Grosso, Annamaria Cerrotta, Carlo Fallai, Patrizia Olmi

Research output: Contribution to journalArticle

Abstract

Aims and background: In vivo and phantom dosimetry is reported to estimate the fetal dose and evaluate the effectiveness of a special shielding device to reduce fetal exposure in a woman undergoing postoperative radiation therapy for synovial oral cavity sarcoma at the 30th week of pregnancy. Methods: In vivo measurements were performed by placing thermoluminescent dosimeters on 3 points for fetal dose estimation: uterine fundus, umbilicus and pubis. A Rando anthropomorphic phantom was used to simulate radiotherapy. We also performed off-axis dose measurements for wedged beams to estimate the dose contribution of this accessory used in the treatment. Results: The special shielding device reduced the fetal dose by 70% on average, despite the presence of wedges, which increased the dose by a factor of about 2.5. Before delivery the patient received 48 Gy, and from the in vivo measurements a fetal dose of 8.5, 1.7 and 0.7 cGy was estimated to the uterine fundus, umbilicus and pubis, respectively. Conclusions: Pre-treatment simulation in the same irradiation conditions is the only reliable approach to predict the fetal dose. By using a special shielding device, radiotherapy can be optimized while keeping the fetal exposure below the risk of deterministic damage.

Original languageEnglish
Pages (from-to)45-52
Number of pages8
JournalTumori
Volume93
Issue number1
Publication statusPublished - Jan 2007

Keywords

  • Fetal dose
  • Oral cavity
  • Pregnancy
  • Radiation therapy
  • Synovial sarcoma

ASJC Scopus subject areas

  • Cancer Research

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