Abstract # 2057 "Alopecia-less" Whole Brain Radiotherapy (WBRT) via IMRT: Preliminary Experience and Outcomes

Presenter: Ting, Joseph

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No patient suffered any acute skin toxicity. All patients had at least some remaining hair at the end of treatment and in first follow-up 4 weeks later. Six patients had no hair loss, and 8 patients had subjectively mild hair loss (with no significant dose correlation noted). DVH analysis of 3-field IMRT plans showed uniformly lower V90, V80, etc., scalp doses versus equal-dose parallel opposed plans. By the Wilcoxon signed rank test, the IMRT plans had a smaller maximum dose (106.7 +/- 0.6%) than the 2-field plans (113.4 +/- 2.4%, p = 0.001) when normalizing such that 100% of the prescribed dose covered 99% of the CTV. The mean scalp dose of the IMRT plans (17.2 +/- 1.9 Gy) was significantly less than the 2-field plans (25.2 +/- 2.3 Gy, p = 0.001). See Figure 4 for representative DVHs/isodose curves. We began using this method approximately one year ago (median follow-up of 5 months). Two patients have died (without CNS progression), and one survivor has suffered CNS progression.

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