Tóm tắt

ABSTRACT
Purpose: To give advantages and disadvantages in pediatric Craniospinal Irradiation (CSI) planning with general anesthesia, to evaluate some criteria about doses covering at Planning Target Volume (PTV), Organs At Risk (OARs) and junction areas.
Materials and Methods: There were 10 pediatric patients with an average age of 4 years (minimum 2 years, maximum 7 years) underwent CSI technique with general anesthesia from August 2017 to August 2018. We applied 3D-CRT (3D conformal radiation therapy) technique for CSI (plan 1) and Volumetric Modulated Arc Therapy technique (VMAT) to boost primary tumor. All processes of taking CT simulation and daily radiotherapy delivery in pediatric patients were done under general anesthetic. Radiotherapy was
given on Linac of Elekta AXESSE, Image Guided Radiotherapy performed by cone beam CT/XVI device, radiotherapy plans were made by XiO 5.10 and Monaco 5.11.
Results and Discussion: Prescribed dose 54Gy (30 fractions). The medium coverage dose at PTV1 was 90%, PTV2 95% the medium high dose (hotspot) at the junction areas was 115%. Critical organs such as lungs, liver, kidneys, optic nerves, brainstem ... received the acceptance limited dose.
Conclusion: Pediatric Craniospinal Irradiation is completely done with general anesthesia. The advantages of CSI are high accuracy and efficacy. Furthermore, the rotation treatment couch in 270 degrees for planning and treatment would limit high dose and missing dose at the junction areas. The disadvantages are taking a long time in planning and treatment delivery, requiring many official persons involved.