Radiotherapy of Hodgkin's disease in early pregnancy: embryo dose measurements.

摘要

BACKGROUND AND PURPOSE: Limited information exists on the possibility of pregnant women undergoing radiotherapy for Hodgkin's disease in early pregnancy. The purpose of this study was to measure embryo dose resulting from treatment of supra-diaphragmatic Hodgkin's disease at the first trimester of gestation.MATERIALS AND METHODS: A humanoid phantom was used to simulate pregnancy at the first trimester of gestation. Embryo dose, was measured using three different field sizes that may be applied for local field irradiation in each of the regions of neck, axilla, neck-mediastinum and for mantle treatment. A shielding device consisting of 5cm of lead was used to reduce the embryo dose. Dose measurements were carried out using thermoluminescent dosimeters. Phantom exposures were made with a 6MV photon beam.RESULTS:Local field irradiation in the regions of neck or axilla always resulted in embryo doses below 10cGy. For local field irradiation in the region of neck-mediastinum and for mantle treatment, the radiation dose to a shielded embryo was 2.8-18.6 and 4.2-24.5cGy depending upon the distance from the field isocenter and the field size used, respectively. The corresponding dose for an unshielded embryo exceeded 10cGy. All the above embryo doses were obtained for a tumor dose of 40Gy.CONCLUSIONS: Local field irradiation in the regions of neck or axilla may be safely performed even without uterus shielding. For local field irradiation in the region of neck-mediastinum and for mantle radiotherapy, the extent of the irradiated area, the distance separating the embryo from the field isocenter and the tumor dose are the factors, determining whether the radiation dose to a shielded embryo may possibly be reduced below 10cGy.