Applied Radiobiology and Bioeffect Planning

Wigg, D.R.

doi:10.1120/1.1435082

Cited by 47 publications

(68 citation statements)

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“…. 7 An α/β ratio of 2 Gy was selected for the late responding normal brain tissue 8 and 10 Gy for brain tumor. 9 The cumulative EQD2 is defined as the sum of the EQD2 of the initial irradiation course and the EQD2 of the reirradiation course (EQD2 cumulative = EQD2 initial + EQD2 reirradiation ).…”

Section: Retreatmentmentioning

confidence: 99%

Spinal Cord Stimulation as Adjuvant During Chemotherapy and Reirradiation Treatment of Recurrent High-Grade Gliomas

et al. 2014

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Aims. Relapsed high-grade gliomas (HGGs) have poor prognoses and there is no standard treatment. HGGs have ischemia/ hypoxia associated and, as such, drugs and oxygen have low access, with increased resistance to chemotherapy and radiotherapy. Tumor hypoxia modification can improve outcomes and overall survival in some patients with these tumors. In previous works, we have described that cervical spinal cord stimulation can modify tumor microenvironment in HGG by increasing tumor blood flow, oxygenation, and metabolism. The aim of this current, preliminary, nonrandomized, study was to assess the clinical effect of spinal cord stimulation during brain reirradiation and chemotherapy deployed for the treatment of recurrent HGG; the hypothesis being that an improvement in oxygenated blood supply would facilitate enhanced delivery of the scheduled therapy. Materials and methods. Seven patients had spinal cord stimulation applied during the scheduled reirradiation and chemotherapy for the treatment of recurrent HGG (6 anaplastic gliomas and 1 glioblastoma). Median dose of previous irradiation was 60 Gy (range = 56-72 Gy) and median dose of reirradiation was 46 Gy (range = 40-46 Gy). Primary end point of the study was overall survival (OS) following confirmation of HGG relapse. Results. From the time of diagnosis of last tumor relapse before reirradiation, median OS was 39 months (95% CI = 0-93) for the overall study group: 39 months (95% CI = 9-69) for those with anaplastic gliomas and 16 months for the patient with glioblastoma. Posttreatment, doses of corticosteroids was significantly decreased (P = .026) and performance status significantly improved (P = .046). Conclusions. Spinal cord stimulation during reirradiation and chemotherapy is feasible and well tolerated. In our study, spinal cord stimulation was associated with clinical improvement and longer survival than previously reported in recurrent anaplastic gliomas. Spinal cord stimulation as adjuvant during chemotherapy and reirradiation in relapsed HGGs merits further research.

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Section: Retreatmentmentioning

confidence: 99%

Spinal Cord Stimulation as Adjuvant During Chemotherapy and Reirradiation Treatment of Recurrent High-Grade Gliomas

et al. 2014

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“…The earliest extension in the literature is the introduction of the dose modifying factor (DMF), also known as the sensitizer enhancement ratio (SER), to account for the additional biological damage caused by the chemotherapeutic agent. It is defined as the ratio of radiation doses with and without the chemotherapeutic agent that lead to the same biological effect (Wigg, 2001). However, the DMF does not distinguish between additivity and radio-sensitization mechanisms and does not consider the drug's concentration.…”

Section: Crt Dose-response Modelmentioning

confidence: 99%

A mathematical programming approach to the fractionation problem in chemoradiotherapy

Salari

Unkelbach

Bortfeld

2015

IIE Transactions on Healthcare Systems Engineering

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In concurrent chemoradiotherapy, chemotherapeutic agents are administered during the course of radiotherapy to enhance the primary tumor control. However, that often comes at the expense of increased risk of normal-tissue complications. The additional biological damage is mainly attributed to two mechanisms of action, which are the independent cytotoxic activity of chemotherapeutic agents and their interactive cooperation with radiation. The goal of this study is to develop a mathematical framework to obtain drug and radiation administration schedules that maximize the therapeutic gain for concurrent chemoradiotherapy. In particular, we analyze the impact of incorporating these two mechanisms into the radiation fractionation problem. Considering each mechanism individually, we first derive closed-form expressions for the optimal radiation fractionation regimen and the corresponding drug administration schedule. We next study the case in which both mechanisms are simultaneously present and develop a dynamic programming framework to determine optimal treatment regimens. Results show that those chemotherapeutic agents that interact with radiation may change optimal radiation fractionation regimens. Moreover, administration of chemotherapeutic agents possessing both mechanisms may give rise to optimal non-stationary fractionation schemes.

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“…4 The latter set of ␣ and ␤ values have been ascribed to pediatric glioma cells with an ␣ of 0.3 Ϯ 0.2 and ␤ of 0.03 Ϯ 0.018. 5 The dose-volume histogram for phase I of radiotherapy is representedinFigure2(CTV,clinicaltargetvolume;PTV,planningtarget volume; R cochlea. right cochlea).…”

Section: Journal Of Clinical Oncologymentioning

confidence: 99%

Radiation Therapy and Adjuvant Chemotherapy in a Patient With a Malignant Glioneuronal Tumor and Underlying Ataxia Telangiectasia: A Case Report and Review of the Literature

DeWire

Beltran

Boop

et al. 2013

JCO

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Case ReportA wheelchair-dependent 12-year-old girl with underlying ataxia telangiectasia (A-T) presented with a 1-month history of headache and decline in mobility and was diagnosed with a malignant glioneuronal tumor of the right parietal lobe. A-T was confirmed by genetic testing when the girl was 7 years old. Laboratory testing showed increased chromosomal breakage after in vitro exposure to irradiation (3.02 chromatid abnormalities per cell; normal, 0.06 to 0.4 chromatid abnormalities per cell) and two deleterious sequence variations in the ATM gene (Nt 6934 ins T and Nt 7630-2 AϾC). Clinical manifestations of A-T included sluggish ocular tracking, proprioception difficulties, bilateral dysmetria, dysarthric speech, and ataxia.Brain magnetic resonance imaging (MRI) revealed a right parietal mass that measured 6.4 ϫ 6.0 ϫ 5.6 cm (Fig 1A). A subtotal resection was performed, and the pathologic diagnosis was a malignant glioneuronal tumor. Although not listed in the World Health Organization classification (2007)

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Applied Radiobiology and Bioeffect Planning

Cited by 47 publications

References 0 publications

Spinal Cord Stimulation as Adjuvant During Chemotherapy and Reirradiation Treatment of Recurrent High-Grade Gliomas

Spinal Cord Stimulation as Adjuvant During Chemotherapy and Reirradiation Treatment of Recurrent High-Grade Gliomas

A mathematical programming approach to the fractionation problem in chemoradiotherapy

Radiation Therapy and Adjuvant Chemotherapy in a Patient With a Malignant Glioneuronal Tumor and Underlying Ataxia Telangiectasia: A Case Report and Review of the Literature

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