Hypofractionation Regimens for Stereotactic Radiotherapy for Large Brain Tumors

Yuan, Jiankui; Wang, Jian Z.; Lo, Simon S.; Grecula, J.C.; Ammirati, Mario; Montebello, Joseph F.; Zhang, Hualin; Gupta, Nilendu; Yuh, William T. C.; Mayr, Nina A.

doi:10.1016/j.ijrobp.2007.12.039

Cited by 22 publications

(16 citation statements)

References 27 publications

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“…To simulate a brain cancer, we use an average α/β ratio of 12 Gy and α value of 0.3 Gy −1 , as estimated by Yuan et al (2008) for brain cancers (primary tumors as well as brain metastatic cancers). This gives a β value of 0.025 Gy −2 .…”

Section: Resultsmentioning

confidence: 99%

“…This gives a β value of 0.025 Gy −2 . For the radius of the domain of interest, R , we use 1.9 cm, which is roughly the radius of a sphere of volume 28.8 cm 3 , the volume of a brain metastatic cancer arising from non-small-cell lung cancer, reported in the same paper (Yuan et al, 2008). For the CSC and TC growth rates, we use ln 2 / 3.9 day −1 , where 3.9 is an estimate of the mean potential doubling time of brain metastatic cancer originating from various primary cancers, as measured by flow cytometry (Struikmans et al, 1997).…”

Section: Resultsmentioning

confidence: 99%

“…All simulations involving radiation use a fraction size of 3.8 Gy, delivered once per day on weekdays only. This fraction size is listed by Yuan et al (2008) as part of a hypofractionated stereotactic radiotherapy regimen involving 15 fractions, and it approaches the radiation tolerance for normal brain tissue. We take the total dose of 57.5 Gy listed by Yuan et al (2008) as our constraint on radiation therapy, which appears as a black plane in Figure 3.…”

Section: Resultsmentioning

confidence: 99%

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Mathematical Optimization of the Combination of Radiation and Differentiation Therapies for Cancer

Bachman¹,

Hillen²

2013

Front. Oncol.

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Cancer stem cells (CSC) are considered to be a major driver of cancer progression and successful therapies must control CSCs. However, CSC are often less sensitive to treatment and they might survive radiation and/or chemotherapies. In this paper we combine radiation treatment with differentiation therapy. During differentiation therapy, a differentiation promoting agent is supplied (e.g., TGF-beta) such that CSCs differentiate and become more radiosensitive. Then radiation can be used to control them. We consider three types of cancer: head and neck cancer, brain cancers (primary tumors and metastatic brain cancers), and breast cancer; and we use mathematical modeling to show that combination therapy of the above type can have a large beneficial effect for the patient; increasing treatment success and reducing side effects.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Mathematical Optimization of the Combination of Radiation and Differentiation Therapies for Cancer

Bachman¹,

Hillen²

2013

Front. Oncol.

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“…In addition, since it appears that fractionation will not reduce late oligodendrocyte lineage-associated side effects, these studies indicate that reducing the volume of the brain exposed to radiation is necessary to minimize late normal white matter damage, offering bench-level support for brain tumor radiosurgery protocols. Clinically, HSRT has been shown to be as effective as whole brain radiation with a stereotactic radiosurgery boost in terms of tumor control and survival (39,40). Moreover, in addition to effective tumor control with HSRT, reduced toxicity has also been suggested in patients with brain metastases (41).…”

Section: Discussionmentioning

confidence: 99%

Fractionation Spares Mice From Radiation-Induced Reductions in Weight Gain But Does Not Prevent Late Oligodendrocyte Lineage Side Effects

Begolly

Shrager

Olschowka

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Purpose To determine the late effects of fractionated versus single dose cranial radiation on murine white matter. Methods and Materials Mice were exposed to 0 Gy, 6×6 Gy, or 1×20 Gy cranial irradiation at 10–12 weeks of age. Endpoints were assessed through 18 months from exposure using immunohistochemistry, electron microscopy, and electrophysiology. Results Weight gain was temporarily reduced after irradiation; greater loss was seen after single versus fractionated doses. Oligodendrocyte progenitor cells were reduced early and late after both single and fractionated irradiation. Both protocols also increased myelin g-ratio, reduced the number of nodes of Ranvier, and promoted a shift in the proportion of small, unmyelinated versus large, myelinated axon fibers. Conclusions Fractionation does not adequately spare normal white matter from late radiation side effects.

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“…[5] Various authors have reported that the biological equivalent dose of the total dose delivered in hypofractionated treatments is high compared to the conventional dose regimens when converted using the linear quadratic model or normalized tumor dose method. [67]…”

Section: Introductionmentioning

confidence: 99%

A study on rectal dose measurement in phantom and in vivo using Gafchromic EBT3 film in IMRT and CyberKnife treatments of carcinoma of prostate

Ganapathy¹,

Kurup²,

Murali³

et al. 2013

J Med Phys

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The objective of this study is to check the feasibility of in vivo rectal dose measurement in intensity-modulated radiotherapy (IMRT) and CyberKnife treatments for carcinoma prostate. An in-house pelvis phantom made with bee's wax was used in this study. Two cylindrical bone equivalent materials were used to simulate the femur. Target and other critical structures associated with carcinoma prostate were delineated on the treatment planning images by the radiation oncologist. IMRT treatment plan was generated in Oncentra Master Plan treatment planning system and CyberKnife treatment plan was generated in Multiplan treatment planning system. Dose measurements were carried out in phantom and in patient using Gafchromic EBT3 films. RIT software was used to analyze the dose measured by EBT3 films. The measured doses using EBT3 films were compared with the TPS-calculated dose along the anterior rectal wall at multiple points. From the in-phantom measurements, it is observed that the difference between calculated and measured dose was mostly within 5%, except for a few measurement points. The difference between calculated and measured dose in the in-patient measurements was higher than 5% in regions which were away from the target. Gafchromic EBT3 film is a suitable detector for in vivo rectal dose measurements as it offers the possibility of analyzing the dose at multiple points. In addition, the method of extending this in vivo rectal dose measurement technique as a tool for patient-specific quality assurance check is also analyzed.

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Hypofractionation Regimens for Stereotactic Radiotherapy for Large Brain Tumors

Cited by 22 publications

References 27 publications

Mathematical Optimization of the Combination of Radiation and Differentiation Therapies for Cancer

Mathematical Optimization of the Combination of Radiation and Differentiation Therapies for Cancer

Fractionation Spares Mice From Radiation-Induced Reductions in Weight Gain But Does Not Prevent Late Oligodendrocyte Lineage Side Effects

A study on rectal dose measurement in phantom and in vivo using Gafchromic EBT3 film in IMRT and CyberKnife treatments of carcinoma of prostate

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