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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...

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Autores principales: Stachelek, Gregory C., Grimm, Jimm, Moore, Joseph, Huang, Ellen, Spoleti, Nicholas, Redmond, Kristin J., Lim, Michael, Bettegowda, Chetan, Kleinberg, Lawrence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
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.
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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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