Hypofractionated Stereotactic Image Guided Helical Tomotherapy for the Treatment of Recurrent Glioblastoma

Arpa, D.; Parisi, Elisabetta; Romeo, Antonino; Ghigi, G.; Bellia, Roberto Salvatore; Dipalma, B.; Neri, Elisa; Lagana, Stephen M.; Pascale, Gennaro De; Micheletti, S.; Moretto, Francesco; Riva, Nada; D’Errico, V.; Tesei, Anna; Sarnelli, Anna; Minguzzi, N.; Polico, R.

doi:10.1016/j.ijrobp.2015.07.712

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“…13 Tomotherapy can complete CSI at a time, eliminating the high-dose and low-dose regions brought about by subsection treatment, and has better target area coverage and dose uniformity than IMRT. 3 In this study, both plans met the requirements of the prescribed dose. The HI index in the TOMO group was better than in the IMRT group; however, the CI index in the TOMO group was not superior to that in the IMRT group.…”

Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

“…It avoids the problem of field exposure and has great advantages, including accurate irradiation, uniform dose distribution, protection of endangered organs, and reduction in normal tissue adverse reactions. 3 With the development of radiotherapy technology, the overall survival time of children with such tumors has been increased, and the 5-year survival rate is approximately 72%. 4 Second cancers account for approximately 16% of all cancers, and solid tumors are the leading cause of death among cancer survivors in the United States.…”

Section: Introductionmentioning

confidence: 99%

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The Risk of Radiogenic Second Cancer Based on Differential DVH: Central Nervous System Malignant Tumor in Children

Tan

Luo

Wang

et al. 2019

Technol Cancer Res Treat

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Objectives:To quantify the risk of radiogenic second cancer in pediatric patients receiving hippocampal-sparing craniospinal irradiation either with intensity-modulated radiation therapy or tomotherapy due to the development of a solid second cancer after radiotherapy using the concept of excess absolute risk.Methods:Computed tomography images of 15 pediatric patients who received craniospinal irradiation treatment were selected for this study. For each case, intensity-modulated radiation therapy and tomotherapy plans were computed. Then, the dosimetry parameters were analyzed. Differential dose–volume histograms were generated, and the excess absolute risks were calculated for each plan of each patient.Results:The tomotherapy group was superior to the intensity-modulated radiation therapy group in target area homogeneity index (P < .001). Tomotherapy offered greater hippocampal sparing than intensity-modulated radiation therapy in terms of D 2% (15.66 vs 23.05 Gy, P < .001) and Dmean (9.79 vs 20.29 Gy, P < .001). Tomotherapy craniospinal irradiation induced a much higher risk than intensity-modulated radiation therapy craniospinal irradiation to the thyroid and lungs (excess absolute risk: thyroid 28.7 vs 26.9 per 10 000 PY, P = .010; lung 20.5 vs 18.9 per 10 000 PY, P = .003). Both techniques conferred a higher risk to the stomach, but there was little difference. In addition, the 2 plans induced less carcinogenic risk to the liver (excess absolute risk 4.2 vs 4.0 per 10 000 PY, P = .020).Conclusions:The tomotherapy plan has obvious advantages in the protection of the hippocampus for children undergoing craniospinal irradiation treatment. Tomotherapy increased the risk of radiogenic second cancer in organ at risk, and therefore, it is imperative to take the risk factor into consideration in the formulation of treatment protocols.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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