nach oben

22.04.2024 | Original Article

Dosimetric comparison of advanced radiation techniques for scalp-sparing in low-grade gliomas

verfasst von: Hang Yu, MS, Shuangshuang He, MS, Yisong He, MS, Guyu Dai, MS, Yuchuan Fu, PhD, Xianhu Zeng, PhD, Mengyuan Liu, MS, Ping Ai, MD

Erschienen in: Strahlentherapie und Onkologie

Einloggen, um Zugang zu erhalten

Abstract

Background

Alopecia causes significant distress for patients and negatively impacts quality of life for low-grade glioma (LGG) patients. We aimed to compare and evaluate variations in dose distribution for scalp-sparing in LGG patients with proton therapy and photon therapy, namely intensity-modulated proton therapy (IMPT), intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and helical tomotherapy (HT).

Methods

This retrospective study utilized a dataset comprising imaging data from 22 patients with LGG who underwent postoperative radiotherapy. Treatment plans were generated for each patient with scalp-optimized (SO) approaches and scalp-non-optimized (SNO) approaches using proton techniques and photons techniques; all plans adhered to the same dose constraint of delivering a total radiation dose of 54.04 Gy to the target volume. All treatment plans were subsequently analyzed.

Results

All the plans generated in this study met the dose constraints for the target volume and OARs. The SO plans resulted in reduced maximum scalp dose (D_max), mean scalp dose (D_mean), and volume of the scalp receiving 30 Gy (V₃₀) and 40 Gy (V₄₀) compared with SNO plans in all radiation techniques. Among all radiation techniques, the IMPT plans exhibited superior performance compared to other plans for dose homogeneity as for SO plans. Also, IMPT showed lower values for D_mean and D_max than all photon radiation techniques.

Conclusion

Our study provides evidence that the SO approach is a feasible technique for reducing scalp radiation dose. However, it is imperative to conduct prospective trials to assess the benefits associated with this approach.

Nur mit Berechtigung zugänglich

Low JT, Ostrom QT, Cioffi G et al (2022) Primary brain and other central nervous system tumors in the United States (2014–2018): a summary of the CBTRUS statistical report for clinicians. Neurooncol Pract 9:165–182PubMedPubMedCentral

Miller KD, Ostrom QT, Kruchko C et al (2021) Brain and other central nervous system tumor statistics. CA Cancer J Clin 71:381–406CrossRefPubMed

Brown TJ, Bota DA, Van Den Bent MJ et al (2019) Management of low-grade glioma: a systematic review and meta-analysis. Neurooncol Pract 6:249–258PubMed

Louis DN, Perry A, Reifenberger G et al (2016) The 2016 world health organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed

Claus EB, Walsh KM, Wiencke JK et al (2015) Survival and low-grade glioma: the emergence of genetic information. Neurosurg Focus 38:E6CrossRefPubMedPubMedCentral

Weller M, Van Den Bent M, Tonn JC et al (2017) European association for neuro-oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas. Lancet Oncol 18:e315–e329CrossRefPubMed

Yan Z, Wang J, Dong Q et al (2022) Predictors of tumor progression of low-grade glioma in adult patients within 5 years follow-up after surgery. Front Surg 9:937556CrossRefPubMedPubMedCentral

Duffau H (ed) (2017) Diffuse low-grade gliomas in adults. Springer, Cham https://doi.org/10.1007/978-3-319-55466-2CrossRef

Wang TJC, Mehta MP (2019) Low-grade glioma radiotherapy treatment and trials. Neurosurg Clin N Am 30:111–118CrossRefPubMed

10.

Tabrizi S, Yeap BY, Sherman JC et al (2019) Long-term outcomes and late adverse effects of a prospective study on proton radiotherapy for patients with low-grade glioma. Radiother Oncol 137:95–101CrossRefPubMedPubMedCentral

11.

Dhawan S, Patil CG, Chen C, Cochrane Gynaecological, Neuro-oncology and Orphan Cancer Group et al (2020) Early versus delayed postoperative radiotherapy for treatment of low-grade gliomas. Cochrane Database Syst Rev 1:

12.

Suchonwanit P, McMichael AJ (2018) Alopecia in association with malignancy: a review. Am J Clin Dermatol 19:853–865CrossRefPubMed

13.

In’T Ven L, Compter I, Van Eijsden K et al (2022) Pre-treatment visualization of predicted radiation-induced acute alopecia in brain tumour patients. Clin Transl Radiat Oncol 33:106–111PubMed

14.

Lawenda BD, Gagne HM, Gierga DP et al (2004) Permanent alopecia after cranial irradiation: dose-response relationship. Int J Radiat Oncol Biol Phys 60:879–887CrossRefPubMed

15.

Scoccianti S, Simontacchi G, Greto D et al (2020) Dosimetric predictors of acute and chronic alopecia in primary brain cancer patients treated with volumetric modulated arc therapy. Front Oncol 10:467CrossRefPubMedPubMedCentral

16.

Phillips GS, Freret ME, Friedman DN et al (2020) Assessment and treatment outcomes of persistent radiation-induced alopecia in patients with cancer. JAMA Dermatol 156:963CrossRefPubMed

17.

Torizuka D, Uto M, Umeda K et al (2023) A scalp dose threshold for preventing permanent alopecia in scalp-avoidance whole-brain irradiation with volumetric modulated arc radiation therapy for pediatric patients with Medulloblastomas. Int J Radiat Oncol Biol Phys 116:889–893CrossRefPubMed

18.

Sprave T, Verma V, Förster R et al (2018) Radiation-induced acute toxicities after image-guided intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy for patients with spinal metastases (IRON-1 trial): First results of a randomized controlled trial. Strahlenther Onkol 194:911–920CrossRefPubMed

19.

Van Der Veen J, Nuyts S (2017) Can intensity-modulated-radiotherapy reduce toxicity in head and neck squamous cell carcinoma? Cancers 9:135CrossRef

20.

Sveistrup J, Af Rosenschöld PM, Deasy JO et al (2014) Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance. Radiat Oncol 9:44CrossRefPubMedPubMedCentral

21.

Gondi V, Pugh SL, Tome WA et al (2014) Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933): a phase II multi-institutional trial. J Clin Oncol 32:3810–3816CrossRefPubMedPubMedCentral

22.

Mishra MV, Aggarwal S, Bentzen SM et al (2017) Establishing evidence-based indications for proton therapy: an overview of current clinical trials. Int J Radiat Oncol Biol Phys 97:228–235CrossRefPubMed

23.

Eekers DBP, Roelofs E, Cubillos-Mesías M et al (2019) Intensity-modulated proton therapy decreases dose to organs at risk in low-grade glioma patients: results of a multicentric in silico ROCOCO trial. Acta Oncol 58:57–65CrossRefPubMed

24.

Thurin E, Nyström PW, Smits A et al (2018) Proton therapy for low-grade gliomas in adults: a systematic review. Clin Neurol Neurosurg 174:233–238CrossRefPubMed

25.

Langendijk JA, Lambin P, De Ruysscher D et al (2013) Selection of patients for radiotherapy with protons aiming at reduction of side effects: the model-based approach. Radiother Oncol 107:267–273CrossRefPubMed

26.

Eekers DB, ’T Ven IL, Roelofs E et al (2018) The EPTN consensus-based atlas for CT- and MR-based contouring in neuro-oncology. Radiother Oncol 128:37–43CrossRefPubMed

27.

Takaoka T, Tomita N, Mizuno T et al (2021) Dosimetric comparison of helical tomotherapy and intensity-modulated proton therapy in hippocampus- and scalp-sparing whole brain radiotherapy. Technol Cancer Res Treat 20:153303382110601CrossRef

28.

Lambrecht M, Eekers DBP, Alapetite C et al (2018) Radiation dose constraints for organs at risk in neuro-oncology; the European particle therapy network consensus. Radiother Oncol 128:26–36CrossRefPubMed

29.

Pidikiti R, Patel BC, Maynard MR et al (2018) Commissioning of the world’s first compact pencil-beam scanning proton therapy system. J Appl Clin Med Phys 19:94–105CrossRefPubMed

30.

Grégoire V, Mackie TR (2011) State of the art on dose prescription, reporting and recording in intensity-modulated radiation therapy (ICRU report no. 83). Cancer Radiother 15:555–559CrossRefPubMed

31.

Paus R, Haslam IS, Sharov AA et al (2013) Pathobiology of chemotherapy-induced hair loss. Lancet Oncol 14:e50–e59CrossRefPubMed

32.

Niazi MZK, Chen Y, Liu H et al (2022) Efficacy of scalp-sparing VMAT approach in reducing scalp radiation dose for patients with glioblastoma. Int J Radiat Oncol Biol Phys 114:e76–e77CrossRef

33.

Palma G, Taffelli A, Fellin F et al (2020) Modelling the risk of radiation induced alopecia in brain tumor patients treated with scanned proton beams. Radiother Oncol 144:127–134CrossRefPubMed

34.

Dutz A, Lühr A, Agolli L et al (2019) Development and validation of NTCP models for acute side-effects resulting from proton beam therapy of brain tumours. Radiother Oncol 130:164–171CrossRefPubMed

35.

Hansen CR, Crijns W, Hussein M et al (2020) Radiotherapy treatment plannINg study guidelines (RATING): a framework for setting up and reporting on scientific treatment planning studies. Radiother Oncol 153:67–78CrossRefPubMed

36.

Adeberg S, Harrabi S, Bougatf N et al (2018) Dosimetric comparison of proton radiation therapy, volumetric modulated arc therapy, and three-dimensional conformal radiotherapy based on Intracranial tumor location. Cancers 10:401CrossRefPubMedPubMedCentral

37.

Eulitz J, Troost EGC, Raschke F et al (2019) Predicting late magnetic resonance image changes in glioma patients after proton therapy. Acta Oncol 58:1536–1539CrossRefPubMed

38.

Wang C‑C, McNamara AL, Shin J et al (2020) End-of-range radiobiological effect on rib fractures in patients receiving proton therapy for breast cancer. Int J Radiat Oncol Biol Phys 107:449–454CrossRefPubMedPubMedCentral

39.

Harrabi SB, Seidensaal K, Bauer J et al (2022) Radiation induced contrast enhancement after proton beam therapy in patients with low grade glioma—how safe are protons? Radiother Oncol 167:211–218CrossRefPubMed

40.

Sã BS (2021) Does the uncertainty in relative biological effectiveness affect patient treatment in proton therapy? Radiother Oncol 163:177–184CrossRef

41.

Kern A, Bäumer C, Kröninger K et al (2020) Determination of surface dose in pencil beam scanning proton therapy. Med Phys 47:2277–2288CrossRefPubMed

Titel: Dosimetric comparison of advanced radiation techniques for scalp-sparing in low-grade gliomas
verfasst von: Hang Yu, MS
Shuangshuang He, MS
Yisong He, MS
Guyu Dai, MS
Yuchuan Fu, PhD
Xianhu Zeng, PhD
Mengyuan Liu, MS
Ping Ai, MD
Publikationsdatum: 22.04.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-024-02229-3

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Dosimetric comparison of advanced radiation techniques for scalp-sparing in low-grade gliomas

Abstract

Background

Methods

Results

Conclusion

Neu im Fachgebiet Onkologie

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

Antikörper-Wirkstoff-Konjugat hält solide Tumoren in Schach

Mammakarzinom: Senken Statine das krebsbedingte Sterberisiko?

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

Update Onkologie

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Background

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Neu im Fachgebiet Onkologie

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

Antikörper-Wirkstoff-Konjugat hält solide Tumoren in Schach

Mammakarzinom: Senken Statine das krebsbedingte Sterberisiko?

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

Update Onkologie