Comparison of Linear Accelerator and Helical Tomotherapy Plans for Glioblastoma Multiforme Patients

Koca, Timur; Basaran, Hamit; Sezen, Duygu; Karaca, Sibel; Ors, Yasemin; Arslan, Deniz; Aydin, A.

doi:10.7314/apjcp.2014.15.18.7811

Cited by 12 publications

(7 citation statements)

References 34 publications

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“…This is slightly different from some other studies. Koca et al [29] analyzed the potential dosimetric gains of HT versus the linear accelerator for 21 GBM patients; D98% and mean doses for simultaneous integrated boost (SIB) volume (PTV60) of HI showed statistically significant superiority to the linear accelerator (LINAC) (p < 0:0001). The reasons for the difference may be the following: (i) the sample size of the study was larger than that of Koca et al, and the statistical difference in some values may not be obvious when the sample size is increased; (ii) IMRT plans were made by a different number of coplanar fields.…”

Section: Biomed Research Internationalmentioning

confidence: 99%

Comparison of Dosimetric Gains Provided by Intensity-Modulated Radiotherapy, Volume-Modulated Arc Therapy, and Helical Tomotherapy for High-Grade Glioma

Liu

Wang

et al. 2020

BioMed Research International

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Purpose. Because of the poor prognosis for high-grade glioma (HGG) patients, it is important to increase the dose of the tumor to improve the efficacy while minimizing the dose of organs at risk (OARs). Thus, we evaluated the potential dosimetric gains of helical tomotherapy (HT) versus intensity-modulated radiotherapy (IMRT) or volume-modulated arc therapy (VMAT) for high-grade glioma (HGG). Methods. A total of 42 HGG patients were retrospectively selected who had undergone helical tomotherapy; then, IMRT and VMAT plans were generated and optimized for comparison after contouring crucial neuronal structures for neurogenesis and neurocognitive function. IMRT and VMAT were optimized with the Eclipse treatment planning system (TPS) (Version 11.0.31) and HT using TomoTherapy Hi-Art Software (Version 2.0.7) (Accuray, Madison, WI, USA). All three techniques were optimized for simultaneously delivering 60 Gy to planning target volume (PTV) 1 and 50-54 Gy to PTV2. We also analyzed the homogeneity index (HI) and conformity index (CI) of PTVs and organ at risk (OAR) sparing. Results. There was no significant difference in the PTV coverage among IMRT, VMAT, or HT. As for the HI, HT plans (PTV1 HI: 0.09±0.03, PTV2 HI: 0.17±0.05) had the best homogeneity when compared to IMRT plans (PTV1 HI: 0.10±0.04, PTV2 HI: 0.18±0.04) and VMAT plans (PTV1 HI: 0.11±0.03, PTV2 HI: 0.20±0.03). The CI value of HT (PTV1 CI: 0.98±0.03, PTV2: 0.98±0.05) was closest to the optimal value. Except for the IMRT and VMAT groups, there were statistically significant differences between the other two groups of the CI values in both PTV1 and PTV2. The other comparison values were statistically significant except for the optic nerve, and VMAT had the best sparing of the optic chiasm. The mean and max doses of OARs declined significantly in HT. Conclusions. For high-grade glioma patients, HT had superior outcomes in terms of PTV coverage and OAR sparing as compared with IMRT/VMAT.

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Section: Biomed Research Internationalmentioning

confidence: 99%

Comparison of Dosimetric Gains Provided by Intensity-Modulated Radiotherapy, Volume-Modulated Arc Therapy, and Helical Tomotherapy for High-Grade Glioma

Liu

Wang

et al. 2020

BioMed Research International

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“…This beam is delivered while the patient is moving enabling to better target different tumor sites without the need for a pause between different patient positions. HT was reported to better spare organ at risks than LINAC during GBM radiation therapy (Miwa et al, 2008 ; Koca et al, 2014 ).…”

Section: The Different Gbm Treatments Commercialized or Under Developmentioning

confidence: 99%

Glioblastoma Treatments: An Account of Recent Industrial Developments

Alphandéry

2018

Front. Pharmacol.

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The different drugs and medical devices, which are commercialized or under industrial development for glioblastoma treatment, are reviewed. Their different modes of action are analyzed with a distinction being made between the effects of radiation, the targeting of specific parts of glioma cells, and immunotherapy. Most of them are still at a too early stage of development to firmly conclude about their efficacy. Optune, which triggers antitumor activity by blocking the mitosis of glioma cells under the application of an alternating electric field, seems to be the only recently developed therapy with some efficacy reported on a large number of GBM patients. The need for early GBM diagnosis is emphasized since it could enable the treatment of GBM tumors of small sizes, possibly easier to eradicate than larger tumors. Ways to improve clinical protocols by strengthening preclinical studies using of a broader range of different animal and tumor models are also underlined. Issues related with efficient drug delivery and crossing of blood brain barrier are discussed. Finally societal and economic aspects are described with a presentation of the orphan drug status that can accelerate the development of GBM therapies, patents protecting various GBM treatments, the different actors tackling GBM disease, the cost of GBM treatments, GBM market figures, and a financial analysis of the different companies involved in the development of GBM therapies.

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“…Thus far, there is limited experience comparing the different treatment techniques for LGG. Koca et al [22] published an IMRT versus TOMO plan comparison of 20 glioblastoma patients showing TOMO to be superior to IMRT plans in sparing of OARs with slightly broader low dose ranges. Cao et al [23] compared VMAT with TOMO for 10 body sites concluding comparable plan qualities of VMAT compared to TOMO in most of the cases.…”

Section: Discussionmentioning

confidence: 99%

Intensity-modulated proton therapy decreases dose to organs at risk in low-grade glioma patients: results of a multicentric in silico ROCOCO trial

et al. 2018

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Background and purpose: Patients with low-grade glioma (LGG) have a prolonged survival expectancy due to better discriminative tumor classification and multimodal treatment. Consequently, long-term treatment toxicity gains importance. Contemporary radiotherapy techniques such as intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), tomotherapy (TOMO) and intensity-modulated proton therapy (IMPT) enable high-dose irradiation of the target but they differ regarding delivered dose to organs at risk (OARs). The aim of this comparative in silico study was to determine these dosimetric differences in delivered doses. Material and methods: Imaging datasets of 25 LGG patients having undergone postoperative radiotherapy were included. For each of these patients, in silico treatment plans to a total dose of 50.4 Gy to the target volume were generated for the four treatment modalities investigated (i.e., IMRT, VMAT, TOMO, IMPT). Resulting treatment plans were analyzed regarding dose to target and surrounding OARs comparing IMRT, TOMO and IMPT to VMAT. Results: In total, 100 treatment plans (four per patient) were analyzed. Compared to VMAT, the IMPT mean dose (D mean) for nine out of 10 (90%) OARs was statistically significantly (p < .02) reduced, for TOMO this was true in 3/10 (30%) patients and for 1/10 (10%) patients for IMRT. IMPT was the prime modality reducing dose to the OARs followed by TOMO. Discussion: The low dose volume to the majority of OARs was significantly reduced when using IMPT compared to VMAT. Whether this will lead to a significant reduction in neurocognitive decline and improved quality of life is to be determined in carefully designed future clinical trials.

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Comparison of Linear Accelerator and Helical Tomotherapy Plans for Glioblastoma Multiforme Patients

Cited by 12 publications

References 34 publications

Comparison of Dosimetric Gains Provided by Intensity-Modulated Radiotherapy, Volume-Modulated Arc Therapy, and Helical Tomotherapy for High-Grade Glioma

Comparison of Dosimetric Gains Provided by Intensity-Modulated Radiotherapy, Volume-Modulated Arc Therapy, and Helical Tomotherapy for High-Grade Glioma

Glioblastoma Treatments: An Account of Recent Industrial Developments

Intensity-modulated proton therapy decreases dose to organs at risk in low-grade glioma patients: results of a multicentric in silico ROCOCO trial

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