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Tumor-Treating Field Arrays Do Not Reduce Target Volume Coverage for Glioblastoma Radiation Therapy
PURPOSE: To inform development of procedures for using tumor-treating field arrays (TTFields) during glioblastoma radiation therapy by determining whether the placement and repositioning of arrays affects target volume coverage and cranial skin dose. METHODS AND MATERIALS: Radiation plans from 10 co...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004938/ https://www.ncbi.nlm.nih.gov/pubmed/32051891 http://dx.doi.org/10.1016/j.adro.2019.08.005 |
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author | Stachelek, Gregory C. Grimm, Jimm Moore, Joseph Huang, Ellen Spoleti, Nicholas Redmond, Kristin J. Lim, Michael Bettegowda, Chetan Kleinberg, Lawrence |
author_facet | Stachelek, Gregory C. Grimm, Jimm Moore, Joseph Huang, Ellen Spoleti, Nicholas Redmond, Kristin J. Lim, Michael Bettegowda, Chetan Kleinberg, Lawrence |
author_sort | Stachelek, Gregory C. |
collection | PubMed |
description | PURPOSE: To inform development of procedures for using tumor-treating field arrays (TTFields) during glioblastoma radiation therapy by determining whether the placement and repositioning of arrays affects target volume coverage and cranial skin dose. METHODS AND MATERIALS: Radiation plans from 10 consecutive patients treated for glioblastoma were copied to a cranial phantom and reoptimized for phantom anatomy. Dose distributions were then recalculated on 3 additional computed tomographic scans of the phantom with the TTFields electrode arrays placed over distinct locations on the phantom scalp to compare planning target volume (PTV) coverage and skin dose with and without TTFields in place in varying positions. Percent depth dose curves were also measured for radiation beams passing through the electrodes and compared with commonly used bolus material. RESULTS: The presence of TTFields arrays decreased PTV V97% and D97% by as much as 1.7% and 2.7%, respectively, for a single array position, but this decrease was mitigated by array repositioning. On averaging the 3 array positions, there was no statistically significant difference in any dosimetric parameter of PTV coverage (V95-97%, D95-97%) across all cases compared with no array. Mean increases in skin D1cc and D20cc of 3.1% were calculated for the cohort. Surface dose for TTFields electrodes was less than that with a 5-mm superflab bolus. CONCLUSIONS: Our work demonstrates that placement of TTFields arrays does not significantly affect target volume coverage. We show that repositioning of TTFields arrays, as is required in clinical use, further minimizes any dosimetric changes and eliminates the need for replanning when arrays are moved. A slight, expected bolus effect is observed, but the calculated increases in skin dose are not clinically significant. These data support the development of clinical trials to assess the safety and efficacy of combining concurrent chemoradiotherapy with TTFields therapy for glioblastoma. |
format | Online Article Text |
id | pubmed-7004938 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-70049382020-02-12 Tumor-Treating Field Arrays Do Not Reduce Target Volume Coverage for Glioblastoma Radiation Therapy Stachelek, Gregory C. Grimm, Jimm Moore, Joseph Huang, Ellen Spoleti, Nicholas Redmond, Kristin J. Lim, Michael Bettegowda, Chetan Kleinberg, Lawrence Adv Radiat Oncol Central Nervous System Tumor PURPOSE: To inform development of procedures for using tumor-treating field arrays (TTFields) during glioblastoma radiation therapy by determining whether the placement and repositioning of arrays affects target volume coverage and cranial skin dose. METHODS AND MATERIALS: Radiation plans from 10 consecutive patients treated for glioblastoma were copied to a cranial phantom and reoptimized for phantom anatomy. Dose distributions were then recalculated on 3 additional computed tomographic scans of the phantom with the TTFields electrode arrays placed over distinct locations on the phantom scalp to compare planning target volume (PTV) coverage and skin dose with and without TTFields in place in varying positions. Percent depth dose curves were also measured for radiation beams passing through the electrodes and compared with commonly used bolus material. RESULTS: The presence of TTFields arrays decreased PTV V97% and D97% by as much as 1.7% and 2.7%, respectively, for a single array position, but this decrease was mitigated by array repositioning. On averaging the 3 array positions, there was no statistically significant difference in any dosimetric parameter of PTV coverage (V95-97%, D95-97%) across all cases compared with no array. Mean increases in skin D1cc and D20cc of 3.1% were calculated for the cohort. Surface dose for TTFields electrodes was less than that with a 5-mm superflab bolus. CONCLUSIONS: Our work demonstrates that placement of TTFields arrays does not significantly affect target volume coverage. We show that repositioning of TTFields arrays, as is required in clinical use, further minimizes any dosimetric changes and eliminates the need for replanning when arrays are moved. A slight, expected bolus effect is observed, but the calculated increases in skin dose are not clinically significant. These data support the development of clinical trials to assess the safety and efficacy of combining concurrent chemoradiotherapy with TTFields therapy for glioblastoma. Elsevier 2019-08-28 /pmc/articles/PMC7004938/ /pubmed/32051891 http://dx.doi.org/10.1016/j.adro.2019.08.005 Text en © 2019 Published by Elsevier Inc. on behalf of American Society for Radiation Oncology. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Central Nervous System Tumor Stachelek, Gregory C. Grimm, Jimm Moore, Joseph Huang, Ellen Spoleti, Nicholas Redmond, Kristin J. Lim, Michael Bettegowda, Chetan Kleinberg, Lawrence Tumor-Treating Field Arrays Do Not Reduce Target Volume Coverage for Glioblastoma Radiation Therapy |
title | Tumor-Treating Field Arrays Do Not Reduce Target Volume Coverage for Glioblastoma Radiation Therapy |
title_full | Tumor-Treating Field Arrays Do Not Reduce Target Volume Coverage for Glioblastoma Radiation Therapy |
title_fullStr | Tumor-Treating Field Arrays Do Not Reduce Target Volume Coverage for Glioblastoma Radiation Therapy |
title_full_unstemmed | Tumor-Treating Field Arrays Do Not Reduce Target Volume Coverage for Glioblastoma Radiation Therapy |
title_short | Tumor-Treating Field Arrays Do Not Reduce Target Volume Coverage for Glioblastoma Radiation Therapy |
title_sort | tumor-treating field arrays do not reduce target volume coverage for glioblastoma radiation therapy |
topic | Central Nervous System Tumor |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004938/ https://www.ncbi.nlm.nih.gov/pubmed/32051891 http://dx.doi.org/10.1016/j.adro.2019.08.005 |
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