دورية أكاديمية
أعرض في EDS

Dose-Painting Proton Radiotherapy Guided by Functional MRI in Non-enhancing High-Grade Gliomas.

التفاصيل البيبلوغرافية
العنوان: Dose-Painting Proton Radiotherapy Guided by Functional MRI in Non-enhancing High-Grade Gliomas.
المؤلفون: Zhu Z; Harbin Medical University, No.157, Baojian Road, Nangang District, Harbin City, 150081, Heilongjiang Province, China; Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China., Gong G; Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China., Wang L; Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China., Su Y; Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China., Lu J; Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China., Dong G; Harbin Medical University, No.157, Baojian Road, Nangang District, Harbin City, 150081, Heilongjiang Province, China. Electronic address: dgl64@163.com., Yin Y; Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China. Electronic address: yinyongsd@126.com.
المصدر: Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2024 Sep; Vol. 36 (9), pp. 552-561. Date of Electronic Publication: 2024 May 25.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders Country of Publication: England NLM ID: 9002902 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-2981 (Electronic) Linking ISSN: 09366555 NLM ISO Abbreviation: Clin Oncol (R Coll Radiol) Subsets: MEDLINE
أسماء مطبوعة: Publication: 2003- : London : W.B. Saunders
Original Publication: [London, UK] : Springer International, [c1989-
مواضيع طبية MeSH: Glioma*/radiotherapy , Glioma*/diagnostic imaging , Glioma*/pathology , Proton Therapy*/methods , Magnetic Resonance Imaging*/methods , Radiotherapy Dosage* , Brain Neoplasms*/radiotherapy , Brain Neoplasms*/diagnostic imaging , Radiotherapy Planning, Computer-Assisted*/methods, Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Adult ; Radiotherapy, Intensity-Modulated/methods ; Radiotherapy, Image-Guided/methods ; Organs at Risk/radiation effects ; Aged ; Feasibility Studies
مستخلص: Aims: This study aimed to demonstrate the feasibility and evaluate the dosimetric effect and clinical impact of dose-painting proton radiotherapy (PRT) guided by functional MRI in non-enhancing high-grade gliomas (NE-HGGs).
Materials and Methods: The 3D-ASL and T2 FLAIR MR images of ten patients with NE-HGGs before radiotherapy were studied retrospectively. The hyperintensity on T2 FLAIR was used to generate the planning target volume (PTV), and the high-perfusion volume on 3D-ASL (PTV-ASL) was used to generate the simultaneous integrated boost (SIB) volume. Each patient received pencil beam scanning PRT and photon intensity-modulated radiotherapy (IMRT). There were five plans in each modality: (1) Uniform plans (IMRT60 vs. PRT60): 60Gy in 30 fractions to the PTV. (2)-(5) SIB plans (IMRT72, 84, 96, 108 vs. PRT72, 84, 96, 108): Uniform plan plus additional dose boost to PTV-ASL in 30 fractions to 72, 84, 96, 108 Gy. The dosimetric differences between various plans were compared. The clinical effects of target volume and organs at risk (OARs) were assessed using biological models for both tumor control probability (TCP) and normal tissue complication probability (NTCP).
Results: Compared with the IMRT plan, the D2 and D50 of the PRT plans with the same prescription dose increased by 1.27-4.12% and 0.64-2.01%, respectively; the R30 decreased by > 32%; the dose of brainstem and chiasma decreased by > 27% and >32%; and the dose of normal brain tissue (Br-PTV), optic nerves, eyeballs, lens, cochlea, spinal cord, and hippocampus decreased by > 50% (P < 0.05). The maximum necessary dose was 96GyE to achieve >98% TCP for PRT, and it was 84Gy to achieve >91% TCP for IMRT. The average NTCP of Br-PTV was 1.30% and 1.90% for PRT and IMRT at the maximum dose escalation, respectively. The NTCP values of the remaining OARs approached zero in all PRT plans.
Conclusion: The functional MRI-guided dose escalation using PRT is feasible while sparing the OARs constraints and demonstrates a potential clinical benefit by improving TCP with no or minimal increase in NCTP for tissues outside the PTV. This retrospective study suggested that the use of PRT-based SIB guided by functional MRI may represent a strategy to provide benefits for patients with NE-HGGs.
(Copyright © 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)
فهرسة مساهمة: Keywords: Dose painting; Function magnetic resonance imaging; Glioma; Proton radiotherapy; Three-dimensional arterial spin labeling
تواريخ الأحداث: Date Created: 20240614 Date Completed: 20240803 Latest Revision: 20240803
رمز التحديث: 20240804
DOI: 10.1016/j.clon.2024.05.011
PMID: 38876805
قاعدة البيانات: MEDLINE
الوصف
تدمد:1433-2981
DOI:10.1016/j.clon.2024.05.011