Evaluation of Anatomical and Dosimetric Changes in the Tumor and Organs at Risk During Radiotherapy with a Tomotherapy Device for Brain Tumors and Investigation of the Necessity of Adaptive Radiation Therapy

Document Type : Original Article(s)

Authors

1 Professor, Medical Image and Signal Processing Research Center, School of Advanced Technologies in Medicine, AND Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Medical Physics Division, Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA

4 BSc student, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

10.48305/jims.v43.i812.0401

Abstract

Background: There are different opinions about anatomical and dosimetric changes during radiotherapy of brain tumors. The aim of this study was to evaluate anatomical and dosimetric changes of the tumor and organs at risk (OARs) during radiotherapy and to assess the necessity of adaptive radiotion therapy (ART).
Methods: This cross-sectional descriptive-analytic study was conducted on 44 patients with brain tumors treated with helical tomotherapy. Differences in planning target volume (PTV) and OARs' volume and dose were obtained at the treatment planning stage, the first and last treatment fractions. The difference between the actual cumulative doses at the last fraction and the initial planned doses was used to evaluate ART necessity.
Findings: Up to 9.09% of all patients with brain tumors received an overdose to some of their OARs (brainstem) due to anatomical changes during radiotherapy and required ART. About 20.45% of all patients received a dose above the tissue tolerance level due to the proximity of their OARs to the tumor at the treatment planning stage, and the volume and dose changes during radiotherapy did not cause this overdose.
Conclusion: Considering how much anatomical changes lead to each organ receiving a dose that exceeds its tolerance, a small percentage of patients needed ART. On the other hand, reducing the time interval between simulation and the first treatment session could play a more significant role in reducing differences during radiotherapy stages.

Highlights

Ali Chaparian: Google Scholar, PubMed

Mahsa Kianinia: Google Scholar, PubMed

Hamidreza Nourzadeh: Google Scholar, PubMed

Keywords

Main Subjects

References

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Journal of Isfahan Medical School
Volume 43, Issue 812
4th Week, June
May and June 2025
Pages 401-410

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History

  • Receive Date: 25 March 2025
  • Accept Date: 15 June 2025

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