Facial deformation following treatment for orbital rhabdomyosarcoma in children The difference between treatment modalities Marinka Hol MD Department of Head and neck surgery and Maxillofacial Surgery AMC Amsterdam ID: 913044
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Slide1
Financial Relationships
No relevant financial relationship(s) exist
Slide2Facial deformation following treatment
for orbital
rhabdomyosarcoma in childrenThe difference between treatment modalities
Marinka Hol, MDDepartment of Head and neck surgery and Maxillofacial Surgery, AMC Amsterdam
Slide3Introduction
Slide4Rhabdomyosarcoma
40% in head
and neck are
Median age at diagnosis
4 years of age
Slide5Rhabdomyosarcoma
40%
Median age at diagnosis
4 years of age
Slide6Treatment options
EBRT
External Beam
Radiotherapy
Photons
Brachytherapy
Chirurgie
AMORE
Surgery
+
Brachytherapy
AMORE
Surgery
+
EBRT
External Beam
Radiotherapy
Protons
Slide7Treatment options
EBRT
External Beam
Radiotherapy
Photons
Brachytherapy
Chirurgie
AMORE
Surgery
+
Brachytherapy
AMORE
Surgery
+
EBRT
External Beam
Radiotherapy
Protons
Slide8AMORE
EBRT
Brachytherapy
Chirurgie
AMORE
Surgery
+
Brachytherapy
AMORE
A
blative surgery
MO
ulage
technique with after loading brachytherapy
RE
constructive
surgery
Slide9Expected differences
EBRT Photon plan
AMORE Brachytherapy plan
Slide10Late adverse events - Quantitative
Schoot
et al.. Adverse
events of local treatment in long-term head and neck rhabdomyosarcoma survivors after external beam radiotherapy or AMORE
treatment. EJC 2015
Slide11Aim
Determine qualitative differences of
the
musculo-skeletal deformities
between EBRT (photons) and AMORE-based patients.
Slide12Methods
Slide13Method
All patients treated between 1990 – 2014 for orbital RMS
AMORE
EBRT - photons
Slide14Method
All patients treated between 1990 - 2014
AMORE
EBRT – photons
Slide15Method
Hol
et al. Analyzing
3D stereophotographs: a new method for the automatic segmentation of the human face into facial esthetic units using the Coherent Point Drift
algorithm (submitted)
Slide16Results
Slide17Orbital Rhabdomyosarcoma patients
AMORE- based (n=14)
EBRT-based (n=15)
Mean Age at Diagnosis
7.4
6.3
Male
60%
50%
Mean Follow-Up
10.5 years
12.0 years
Mean
age at follow-up1818
Slide18Surface area
AMORE (n=14)
EBRT (n=15)
Healthy Population
Treated Orbit
60%
70%
100%
Contralateral orbit
98%
80%
100%
Radiated
side of face95%
83%
100%
Contralateral side of face
100%
85%
100%
> 2 SD differences to healthy population
Slide19Curvature
Deformed Curvature
Normal Curvature
Slide20Curvature
Deformed Curvature
Normal Curvature
EBRT – based patients
AMORE – based patients
Slide21Conclusion
Surface in EBRT patients and AMORE patients affected at tumor side, however in EBRT the non-radiated side also affected
Curvature in EBRT more affected in contralateral and non-radiated side
Growth disruption less severe in AMORE-based patient
Slide22Next Step
EBRT
External Beam
Radiotherapy
Photons
Brachytherapy
Chirurgie
AMORE
Surgery
+
Brachytherapy
AMORE
Surgery
+
EBRT
External Beam
Radiotherapy
Protons
Include all head and neck RMS
Include all treatment options
Slide23Next Step
EBRT
External Beam
Radiotherapy
Photons
Brachytherapy
Chirurgie
AMORE
Surgery
+
Brachytherapy
AMORE
Surgery
+
EBRT
External Beam
Radiotherapy
Protons
Slide24Next Step
EBRT
External Beam
Radiotherapy
Photons
Brachytherapy
Chirurgie
AMORE
Surgery
+
Brachytherapy
AMORE
Surgery
+
EBRT
External Beam
Radiotherapy
Protons
Goal: Develop a prediction model to choose optimal treatment considering patient and tumor characteristics
Slide25Thank you for your time and attention
T.
Alderliesten
A.G.
Becking
A. Bel
R.
Dávila
-Fajardo
N.J.
Freling
L.C. Kremer
J.H.M.
Merks
B.R.
Pieters
C.R.N.
Rasch
C.M.
Ronckers
P. Saeed
R.
Schoot
L.E.
Smeele
S.D
Strackee
J.
Wiersma
J.C. ChrisholmM.N. GazeH.C.
Mandeville
O. Slater
All patients