Risk of carotid blowout after reirradiation with particle therapy

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Presentation transcript:

Risk of carotid blowout after reirradiation with particle therapy Jon Espen Dale, MD, Silvia Molinelli, MSc, Elisa Ciurlia, MD, Mario Ciocca, MSc, Maria Bonora, MD, Viviana Vitolo, MD, Alfredo Mirandola, MSc, Stefania Russo, MSc, Roberto Orecchia, MD, Olav Dahl, PhD, MD, Piero Fossati, MD Advances in Radiation Oncology Volume 2, Issue 3, Pages 465-474 (July 2017) DOI: 10.1016/j.adro.2017.05.007 Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 1 Dose distribution from (A) first photon treatment (70 Gy), (B) reirradiation at CNAO with carbon ions (54 Gy [RBE]) and (C) cumulative nominal dose. The carotid artery is outlined in black and demonstrates the selective sparing of the carotid artery in (B). Advances in Radiation Oncology 2017 2, 465-474DOI: (10.1016/j.adro.2017.05.007) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 2 Patient selection. Advances in Radiation Oncology 2017 2, 465-474DOI: (10.1016/j.adro.2017.05.007) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 3 CumDmaxEQD2 for all 74 carotid arteries, displaying the contribution from photon radiation therapy (RT) (blue), carbon RT (pink), and proton RT (purple). * Carotid arteries of the 2 patients who developed oronasal hemorrhage. Advances in Radiation Oncology 2017 2, 465-474DOI: (10.1016/j.adro.2017.05.007) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 4 Dose corresponding to ≥90% of CumD1nom (115-129 Gy [RBE]). V90%CumD1 for this patient was 0.28 cm3. Advances in Radiation Oncology 2017 2, 465-474DOI: (10.1016/j.adro.2017.05.007) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 5 Cumulative carotid blowout (CB) rate. The table displays the absolute number of patients who were at risk of CB, death due to CB, death due to cause other than CB, and loss to follow-up at the end of each 6-month interval. Advances in Radiation Oncology 2017 2, 465-474DOI: (10.1016/j.adro.2017.05.007) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions