# Retrospective NCI Phantom-Monte Carlo Dosimetry for Late Effects in Wilms Tumor

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2020 · $549,997

## Abstract

PROJECT SUMMARY
Radiation therapy is the most important contributor to late toxicity in children. Unlike in adults, there is not
much data on three-dimensional (3D) normal tissue radiation tolerance in children. This retrospective
dosimetry study will use the patient-matched NCI computational pediatric phantom model for conducting Monte
Carlo dosimetry analysis. This study will be performed on matched phantoms of all 5000 children with Wilms
tumor (WT) who received radiation therapy (RT) on five National Wilms Tumor Study (NWTS) protocols during
1969-2002. The high survivorship (90%) of WT and the many advantages of the NWTS late effects database
makes this an ideal platform for a detailed dosimetry study of late effects of therapy. One patient-matched
phantom based on height, weight, age and sex of each NWTS patient, with already pre-contoured target
organs will be selected from the phantom library of Dr. Lee at the NCI. This phantom will be imported into the
radiation treatment planning system for reconstruction of NWTS radiation fields. While modern RT treatment
planning systems (TPS) are fairly accurate for estimating doses both in-field and near-field locations, this
method is not suitable for out-of-field dose measurements. The Monte Carlo (MC) dose calculation algorithm
has overcome this deficiency of TPS and measures out-of-field doses more accurately. In this study, both
dosimetry models will be used for estimating doses in-field, and MC-based dose calculations will be used for
estimating out-of-field doses. For AIM 1 of this study, we will collect target organ 3D dosimetry data for 13
organs including thyroid, heart (total heart, ventricles and myocardium), lungs, kidneys, liver, chest wall,
stomach, colon, breasts, uterus, ovaries, pelvis and testicles. For AIM 2 we will review and validate
reproductive late effects (hypogonadism and infertility) among males and females recorded in the NWTS
database and conduct a prospective questionnaire-based cohort study to determine their prevalence among
NWTS survivors. For AIM 3 we will study the association between RT dose to target organs estimated using
the NCI Phantom MC dosimetry model and six late effects ascertained by the NWTS including: congestive
heart failure (heart, ventricles, myocardium), restrictive pulmonary disease (lungs, chest wall), second
malignant neoplasms (lung, thyroid, breasts, liver stomach, colon), end stage renal disease (kidney/s), adverse
pregnancy outcomes (ovaries, uterus, pelvis) and additional reproductive outcomes (hypogonadism and
infertility – ovaries, uterus in females and testicles in males). A comprehensive knowledge of 3D organ
tolerance will help reduce the incidence of RT induced late toxicity and minimize their adverse impact on
current and future childhood cancer survivors.

## Key facts

- **NIH application ID:** 9980351
- **Project number:** 5R01CA219013-04
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** John Andrew Kalapurakal
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $549,997
- **Award type:** 5
- **Project period:** 2017-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9980351

## Citation

> US National Institutes of Health, RePORTER application 9980351, Retrospective NCI Phantom-Monte Carlo Dosimetry for Late Effects in Wilms Tumor (5R01CA219013-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9980351. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*