Hippocampal sparing radiotherapy for glioblastoma patients: a planning study using volumetric modulated arc therapy

Hofmaier, Jan; Kantz, Steffi; Söhn, Matthias; Dohm, O.; Bächle, Stefan; Alber, M.; Parodi, Katia; Belka, Claus; Niyazi, Maximilian

doi:10.1186/s13014-016-0695-6

Cited by 15 publications

(11 citation statements)

References 38 publications

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“…The study by Posti et al 14 reported main presenting symptoms as seizures and cognitive disorder. Cognitive 17 study showed increased female cases, studies have shown that gender plays a prognostic role in survival of GBM cases due to estrogen hormone acting as a protective function though no clear-cut evidence could be collected, reseach work is ongoing to find out its importance but as far as our study is concerned, we found similar result as Canyilmaz et al 15 and Hofmaier et al 16 study.…”

Section: Agesupporting

confidence: 82%

Comparison of Hippocampal Sparing Intensity Modulated Radiotherapy Plans in Patients of Brain Tumors treated by Three-dimensional Conformal Radiotherapy

Chaturvedi

Kumar²,

Chauhan³

et al. 2022

SRMsJMS

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Introduction: Radiotherapy plays a key role in brain tumorsafter surgery. However, concerns regarding neurocognitivetoxicity after radiotherapy are being raised. Newer radiotherapytechniques can deliver radiotherapy with better precisionplanning and delivery. Effective hippocampal sparing is possiblewith IMRT which governs the neurocognitive functions. Thepresent study is done to compare whether hippocampal sparingis possible in brain tumors by 3D Conformal Radiotherapyand Intensity Modulated Radiotherapy and their effects onneurocognitive functions.Materials and Methods: Twenty-two patients with brain cancerwere recruited from November 2019 to April 2021. Patients weretreated with 3D-CRT technique and alternate IMRT plans weregenerated. Dosimetric parameters of PTV, organs at risk alongwith hippocampus were evaluated and compared for 3DCRTand IMRT plans. Neurocognitive functions were evaluatedusing MMSE score.Result: In study group, there were 16 males and 6 females withmedian age 45 years. Brain tumors were commonly located infrontal lobe (36%) followed by parieto-occipital lobe (18%) andfronto-temporo-parietal lobe (13.63%). PTV parameters werebetter for IMRT and statistically significant. The OARs did notshow significant difference except in both lens though they arewithin tolerance limits. There is no significant difference in thedosimetric parameters of hippocampus in 3D-CRT and IMRTplans. The p-value for Dmax is 0.79, Dmean is 0.26, Dmin is0.18 between hippocampal sparing radiotherapy plans.Conclusion: Anatomic location of tumor plays a key role indeciding hippocampal sparing. Patients whose NCFs showedimprovement on subsequent visits, highlights the fact thatprimary tumor control is a key factor in deciding decline orimprovement in NCFs. It should be beneficial for LGG that havebetter survival and prognosis as compared to HGG cases.

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Section: Agesupporting

confidence: 82%

Comparison of Hippocampal Sparing Intensity Modulated Radiotherapy Plans in Patients of Brain Tumors treated by Three-dimensional Conformal Radiotherapy

Chaturvedi

Kumar²,

Chauhan³

et al. 2022

SRMsJMS

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“…The hippocampus has been shown to be important for several neurocognitive functions [ 23 – 26 ]. Thus, additionally to the common known structures like hippocampus, subventricular zone, amygdale and thalamus, it may be essential to focus also on the cerebral cortex as an important OAR [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Cerebral cortex dose sparing for glioblastoma patients: IMRT versus robust treatment planning

et al. 2018

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BackgroundTo date, patients with glioblastoma still have a bad median overall survival rate despite radiation dose-escalation and combined modality treatment. Neurocognitive decline is a crucial adverse event which may be linked to high doses to the cortex. In a planning study, we investigated the impact of dose constraints to the cerebral cortex and its relation to the organs at risk for glioblastoma patients.MethodsCortical sparing was implemented into the optimization process for two planning approaches: classical intensity-modulated radiotherapy (IMRT) and robust treatment planning. The plans with and without objectives for cortex sparing where compared based on dose-volume histograms (DVH) data of the main organs at risk. Additionally the cortex volume above a critical threshold of 28.6 Gy was elaborated. Furthermore, IMRT plans were compared with robust treatment plans regarding potential cortex sparing.ResultsCortical dose constraints result in a statistically significant reduced cerebral cortex volume above 28.6 Gy without negative effects to the surrounding organs at risk independently of the optimization technique. For IMRT we found a mean volume reduction of doses beyond the threshold of 19%, and 16% for robust treatment planning, respectively. Robust plans delivered sharper dose gradients around the target volume in an order of 3 – 6%. Aside from that the integration of cortical sparing into the optimization process has the potential to reduce the dose around the target volume (4 – 8%).ConclusionsWe were able to show that dose to the cerebral cortex can be significantly reduced both with robust treatment planning and IMRT while maintaining clinically adequate target coverage and without corrupting any organ at risk. Robust treatment plans delivered more conformal plans compared to IMRT and were superior in regards to cortical sparing.

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“…Statistically significant correlations between the doses delivered to the hippocampi and late decline in neuropsychological tests performed following focal brain radiotherapy have been highlighted [5]. Following these results, radiation techniques sparing the hippocampi, especially using intensity-modulated radiation therapy (IMRT) approaches have been developed [6].…”

Section: Introductionmentioning

confidence: 99%

Dose distribution of the brain tissue associated with cognitive functions in high-grade glioma patients

Jacob¹,

Clausse²,

Benadjaoud³

et al. 2020

Cancer/Radiothérapie

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Hippocampal sparing radiotherapy for glioblastoma patients: a planning study using volumetric modulated arc therapy

Cited by 15 publications

References 38 publications

Comparison of Hippocampal Sparing Intensity Modulated Radiotherapy Plans in Patients of Brain Tumors treated by Three-dimensional Conformal Radiotherapy

Comparison of Hippocampal Sparing Intensity Modulated Radiotherapy Plans in Patients of Brain Tumors treated by Three-dimensional Conformal Radiotherapy

Cerebral cortex dose sparing for glioblastoma patients: IMRT versus robust treatment planning

Dose distribution of the brain tissue associated with cognitive functions in high-grade glioma patients

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