Hippocampal Sparing in Dose-Painting Radiotherapy in High-Grade Glioma

Document Type : Original Article (s)

Authors

1 MSc Student, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 PhD Student, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study aimed to determine hippocampal absorbed dose in radiotherapy of high-grade brain glioma using dose painting method and to compare it with intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT).Methods: In Milad hospital radiotherapy section in Isfahan, Iran, images from 24 patients with high-grade brain glioma were acquired. All radiotherapy volumes for patients were defined and then, at risk organ was contoured. There were 4 planning target volumes (PTVs) defined for each patient. PTV4 just has been defined for dose painting method and the given dose was increased up to 72 Gy in this method. Finally for each patient, by using treatment planning system characteristics, 3 methods were simulated and the optimal technique was represented.Findings: The average hippocampus-received dose was 4.772, 4.174, and 5.668 Gy in 3D-CRT, IMRT, and dose painting methods, respectively. Increasing the dose in dose painting method by 1.2% than in IMRT method resulted in 1.357% increasing in hippocampal-absorbed dose; considering the hippocampal tolerance dose, it would not cause serious injury and in return tumors, would be controlled more effectively.Conclusion: In this study, the importance of multi-parametric magnetic resonance imaging (MRI) in dose painting method was achieved. As by using these images for determining the different parts of tumor, tumor-received dose significantly increased; while the organs around the tumor received no serious damage.

Keywords

References

  1. Gladson CL, Prayson RA, Liu WM. The pathobiology of glioma tumors. Annu Rev Pathol 2010; 5: 33-50.
  2. Dirix P, Nuyts S. Evidence-based organ-sparing radiotherapy in head and neck cancer. Lancet Oncol 2010; 11(1): 85-91.
  3. Schwartzbaum JA, Fisher JL, Aldape KD, Wrensch M. Epidemiology and molecular pathology of glioma. Nat Clin Pract Neurol 2006; 2(9): 494-503.
  4. Juratli TA, Schackert G, Krex D. Current status of local therapy in malignant gliomas--a clinical review of three selected approaches. Pharmacol Ther 2013; 139(3): 341-58.
  5. Marsh JC, Ziel GE, Diaz AZ, Wendt JA, Gobole R, Turian JV. Integral dose delivered to normal brain with conventional intensity-modulated radiotherapy (IMRT) and helical tomotherapy IMRT during partial brain radiotherapy for high-grade gliomas with and without selective sparing of the hippocampus, limbic circuit and neural stem cell compartment. J Med Imaging Radiat Oncol 2013; 57(3): 378-83.
  6. Law M, Yang S, Wang H, Babb JS, Johnson G, Cha S, et al. Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol 2003; 24(10): 1989-98.
  7. Marsh JC, Godbole R, Diaz AZ, Gielda BT, Turian JV. Sparing of the hippocampus, limbic circuit and neural stem cell compartment during partial brain radiotherapy for glioma: a dosimetric feasibility study. J Med Imaging Radiat Oncol 2011; 55(4): 442-9.
  8. Yartsev S, Kron T, Cozzi L, Fogliata A, Bauman G. Tomotherapy planning of small brain tumours. Radiother Oncol 2005; 74(1): 49-52.
  9. Farjam R, Pramanik P, Aryal MP, Srinivasan A, Chapman CH, Tsien CI, et al. A Radiation-Induced Hippocampal Vascular Injury Surrogate Marker Predicts Late Neurocognitive Dysfunction. Int J Radiat Oncol Biol Phys 2015; 93(4): 908-15.
  10. Shahbazi-Gahrouei D. Novel MR imaging contrast agents for cancer detection. J Res Med Sci 2009; 14(3): 141-7.
  11. Chera BS, Amdur RJ, Patel P, Mendenhall WM. A radiation oncologist's guide to contouring the hippocampus. Am J Clin Oncol 2009; 32(1): 20-2.
  12. Bleehen NM, Stenning SP. A Medical Research Council trial of two radiotherapy doses in the treatment of grades 3 and 4 astrocytoma. The Medical Research Council Brain Tumour Working Party. Br J Cancer 1991; 64(4): 769-74.
  13. Hunt MA, Burman CM. Treatment planning considerations in IMRT. In: Memorial Sloan-Kettering Cancer Center, editor. A practical guide to intensity-modulated radiation therapy. 1st ed. Madison, WI: Medical Physics Pub Corp; 2003. p. 103-21.
Journal of Isfahan Medical School
Volume 35, Issue 417 - Serial Number 417
January and February 2017
Pages 7-12

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History

  • Receive Date: 26 September 2016
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

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