Organs at risk in the brain and their dose-constraints in adults and in children: A radiation oncologist’s guide for delineation in everyday practice

Scoccianti, Silvia; Detti, Beatrice; Gadda, Davide; Greto, Daniela; Furfaro, Ilaria; Meacci, F.; Simontacchi, Gabriele; Brina, Lucia Di; Bonomo, Pierluigi; Giacomelli, Irene; Meattini, Icro; Mangoni, Monica; Cappelli, Susanna; Cassani, S.; Talamonti, Cinzia; Bordi, Lorenzo; Livi, Lorenzo

doi:10.1016/j.radonc.2015.01.016

Cited by 179 publications

(160 citation statements)

References 47 publications

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“…For primary tumors in close vicinity of the brain, we also recommend defining the temporal lobe and hippocampus (but delineation guidelines for these OARs are beyond the scope of these current guidelines) [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…In the case of nasopharyngeal cancer, a subdivision of brain structures could be made, i.e. delineation of the hippocampus and temporal lobe with the use of a brain atlas [15,16].…”

Section: Brainmentioning

confidence: 99%

“…The atlas in DICOM-RT format can be retrieved via the different co-operative groups. (4), mandible (5), extended oral cavity (6), buccal mucosa (7), lips (8), brain (9), chiasm (10), pituitary gland (11), brainstem (12), supraglottic larynx (13), glottic area (14), cricopharyngeal inlet (15), cervical esophagus (16) and thyroid (17). (For the full atlas, the reader is referred to the Supplemental material.)…”

Section: Carotid Arteriesmentioning

confidence: 99%

See 2 more Smart Citations

CT-based delineation of organs at risk in the head and neck region: DAHANCA, EORTC, GORTEC, HKNPCSG, NCIC CTG, NCRI, NRG Oncology and TROG consensus guidelines

Brouwer

Steenbakkers

Bourhis

et al. 2015

Radiotherapy and Oncology

481

299

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show abstract

Section: Discussionmentioning

confidence: 99%

“…In the case of nasopharyngeal cancer, a subdivision of brain structures could be made, i.e. delineation of the hippocampus and temporal lobe with the use of a brain atlas [15,16].…”

Section: Brainmentioning

confidence: 99%

Section: Carotid Arteriesmentioning

confidence: 99%

See 1 more Smart Citation

CT-based delineation of organs at risk in the head and neck region: DAHANCA, EORTC, GORTEC, HKNPCSG, NCIC CTG, NCRI, NRG Oncology and TROG consensus guidelines

Brouwer

Steenbakkers

Bourhis

et al. 2015

Radiotherapy and Oncology

481

299

View full text Add to dashboard Cite

show abstract

“…The hypothalamus and thalamus were delineated in accordance with previously published contouring landmarks [13,14]. The pituitary gland and optic system were contoured following previous recommendations [15] and the Radiation Therapy Oncology Group (RTOG) contouring atlas. The midbrain, pons, and medulla oblongata were considered together as the brainstem.…”

Section: Tumor Delineation and Oar Delineationmentioning

confidence: 99%

Intensity-modulated proton therapy, volumetric-modulated arc therapy, and 3D conformal radiotherapy in anaplastic astrocytoma and glioblastoma

et al. 2016

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“…15 ). Other organs at risk (optic nerves, chiasm and lenses) were segmented according to recent contouring guidelines 16 . Planning target volume (PTV) contained the whole brain with 5 mm expansion to accommodate random setup uncertainty.…”

Section: Patients and Contouringmentioning

confidence: 99%

Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study

Kazda¹,

Vrzal²,

Procházka³

et al. 2017

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims. Unilateral sparing of the dominant (left) hippocampus during whole brain radiotherapy (WBRT) could mitigate cognitive decline, especially verbal memory, similar to the widely investigated bilateral hippocampus avoidance (HA-WBRT). The aim of this planning study is dosimetrical comparison of HA-WBRT with only left hippocampus sparing (LHA-WBRT) plans. Methods. HA-WBRT plans for 10 patients were prepared in accordance with RTOG 0933 trial and served as baseline for comparisons with several LHA-WBRT plans prepared with an effort: 1) to maintain the same left hippocampus dosimetry ("BEST PTV") and 2) to maintain same dosimetry in planning target volume as in HA-WBRT ("BEST LH"). Results. All HA-WBRT plans met RTOG 0933 protocol criteria with a mean Conformity index 1.09 and mean Homogeneity index (HI) 0.21. Mean right and left hippocampal D100% was 7.8 Gy and 8.5 Gy and mean Dmax 14.0 Gy and 13.8 Gy, respectively. "BEST PTV" plans reduced HI by 31.2% (P=0.005) which is mirrored by lower PTV_D2% (-0.8 Gy, P=0.005) and higher PTV_D98% (+1.3 Gy, P=0.005) as well as decreased optic pathway's Dmax by 1 Gy. In "BEST LH", mean D100% and Dmax for the left hippocampus were significantly reduced by 11.2% (P=0.005) and 10.9% (P=0.005) respectively. Conclusions. LHA-WBRT could improve target coverage and/or further decrease in dose to spared hippocampus. Future clinical trials must confirm whether statistically significant reduction in left hippocampal dose is also clinically significant.

show abstract

Organs at risk in the brain and their dose-constraints in adults and in children: A radiation oncologist’s guide for delineation in everyday practice

Cited by 179 publications

References 47 publications

CT-based delineation of organs at risk in the head and neck region: DAHANCA, EORTC, GORTEC, HKNPCSG, NCIC CTG, NCRI, NRG Oncology and TROG consensus guidelines

CT-based delineation of organs at risk in the head and neck region: DAHANCA, EORTC, GORTEC, HKNPCSG, NCIC CTG, NCRI, NRG Oncology and TROG consensus guidelines

Intensity-modulated proton therapy, volumetric-modulated arc therapy, and 3D conformal radiotherapy in anaplastic astrocytoma and glioblastoma

Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study

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