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Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses

OBJECTIVE: This study aimed to investigate the tumor volume changes occurring during limited-field radiotherapy (RT) for glioblastoma patients and whether a volume-adapted boost planning approach provided any benefit on tumor coverage and normal tissue sparing. MATERIALS AND METHODS: Twenty-four pat...

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Autores principales: Şenkesen, Öznur, Tezcanlı, Evrim, Abacıoğlu, Mehmet Ufuk, Özen, Zeynep, Çöne, Derya, Küçücük, Halil, Göksel, Evren Ozan, Arifoğlu, Alptekin, Şengöz, Meriç
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Radiation Oncology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984129/
https://www.ncbi.nlm.nih.gov/pubmed/35368196
http://dx.doi.org/10.3857/roj.2021.00542
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author Şenkesen, Öznur
Tezcanlı, Evrim
Abacıoğlu, Mehmet Ufuk
Özen, Zeynep
Çöne, Derya
Küçücük, Halil
Göksel, Evren Ozan
Arifoğlu, Alptekin
Şengöz, Meriç
author_facet Şenkesen, Öznur
Tezcanlı, Evrim
Abacıoğlu, Mehmet Ufuk
Özen, Zeynep
Çöne, Derya
Küçücük, Halil
Göksel, Evren Ozan
Arifoğlu, Alptekin
Şengöz, Meriç
author_sort Şenkesen, Öznur
collection PubMed
description OBJECTIVE: This study aimed to investigate the tumor volume changes occurring during limited-field radiotherapy (RT) for glioblastoma patients and whether a volume-adapted boost planning approach provided any benefit on tumor coverage and normal tissue sparing. MATERIALS AND METHODS: Twenty-four patients underwent simulation with magnetic resonance (MR) and computed tomography (CT) scans prior to RT (MR_initial, CT_initial) and boost treatment (MR_adapt, CT_adapt). For the boost phase, MR_initial and MR_adapt images were used to delineate GTV(2) and GTV(2_adapt), respectively. An initial boost plan (Plan_initial) created on CT_initial for PTV(2) was then reoptimized on CT_adapt by keeping the same optimization and normalization values. Plan_adapt was generated on CT_adapt for PTV(2_adapt) volume. Dose volume histogram parameters for target volumes and organs-at-risk were compared using these boost plans generated on CT_adapt. Plan_initial and Plan_adaptive boost plans were summed with the first phase plan and the effect on the total dose was investigated. RESULTS: Target volume expansion was noted in 21% of patients while 79% had shrinkage. The average difference for the initial and adaptive gross tumor volume (GTV), clinical target volume (CTV), and planning target volume (PTV) volumes were statistically significant. Maximum dose differences for brainstem and optic chiasm were significant. Healthy brain tissue V(10) and ipsilateral optic nerve maximum doses were found to decrease significantly in Plan_adaptive. CONCLUSION: Results of this study confirm occurrence of target volume changes during RT for glioblastoma patients. An adaptive plan can provide better normal tissue sparing for patients with lesion shrinkage and avoid undercoverage of treatment volumes in case of target volume expansion especially when limited-fields are used.
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spelling pubmed-89841292022-04-13 Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses Şenkesen, Öznur Tezcanlı, Evrim Abacıoğlu, Mehmet Ufuk Özen, Zeynep Çöne, Derya Küçücük, Halil Göksel, Evren Ozan Arifoğlu, Alptekin Şengöz, Meriç Radiat Oncol J Original Article OBJECTIVE: This study aimed to investigate the tumor volume changes occurring during limited-field radiotherapy (RT) for glioblastoma patients and whether a volume-adapted boost planning approach provided any benefit on tumor coverage and normal tissue sparing. MATERIALS AND METHODS: Twenty-four patients underwent simulation with magnetic resonance (MR) and computed tomography (CT) scans prior to RT (MR_initial, CT_initial) and boost treatment (MR_adapt, CT_adapt). For the boost phase, MR_initial and MR_adapt images were used to delineate GTV(2) and GTV(2_adapt), respectively. An initial boost plan (Plan_initial) created on CT_initial for PTV(2) was then reoptimized on CT_adapt by keeping the same optimization and normalization values. Plan_adapt was generated on CT_adapt for PTV(2_adapt) volume. Dose volume histogram parameters for target volumes and organs-at-risk were compared using these boost plans generated on CT_adapt. Plan_initial and Plan_adaptive boost plans were summed with the first phase plan and the effect on the total dose was investigated. RESULTS: Target volume expansion was noted in 21% of patients while 79% had shrinkage. The average difference for the initial and adaptive gross tumor volume (GTV), clinical target volume (CTV), and planning target volume (PTV) volumes were statistically significant. Maximum dose differences for brainstem and optic chiasm were significant. Healthy brain tissue V(10) and ipsilateral optic nerve maximum doses were found to decrease significantly in Plan_adaptive. CONCLUSION: Results of this study confirm occurrence of target volume changes during RT for glioblastoma patients. An adaptive plan can provide better normal tissue sparing for patients with lesion shrinkage and avoid undercoverage of treatment volumes in case of target volume expansion especially when limited-fields are used. The Korean Society for Radiation Oncology 2022-03 2022-03-28 /pmc/articles/PMC8984129/ /pubmed/35368196 http://dx.doi.org/10.3857/roj.2021.00542 Text en Copyright © 2022 The Korean Society for Radiation Oncology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Şenkesen, Öznur
Tezcanlı, Evrim
Abacıoğlu, Mehmet Ufuk
Özen, Zeynep
Çöne, Derya
Küçücük, Halil
Göksel, Evren Ozan
Arifoğlu, Alptekin
Şengöz, Meriç
Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses
title Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses
title_full Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses
title_fullStr Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses
title_full_unstemmed Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses
title_short Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses
title_sort limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984129/
https://www.ncbi.nlm.nih.gov/pubmed/35368196
http://dx.doi.org/10.3857/roj.2021.00542
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