Intensity modulated radiotherapy (IMRT) for recurrent, residual, or untreated skull-base meningiomas: preliminary clinical experience

Pirzkall, Andrea; Debus, Jürgen; Haering, P.; Rhein, B.; Grosser, Karl Heinz; Höss, Angelika; Wannenmacher, M.

doi:10.1016/s0360-3016(02)03809-9

Cited by 135 publications

(59 citation statements)

References 51 publications

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“…Although numerous comparisons of IMRT and conventional planning have been presented, outcome studies involving patients who were treated with IMRT are limited. [2][3][4][5][6][7][8][9][10] Moreover, most studies include small numbers of patients with limited follow-up data and focus solely on toxicity. Few include analyses of tumor control.…”

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confidence: 99%

Intensity‐modulated radiotherapy and the Internet

Schomas

Milano

Roeske

et al. 2004

Cancer

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BACKGROUNDThe objective of the current study was to evaluate the content and quality of patient‐oriented information regarding intensity‐modulated radiotherapy (IMRT) on the Internet.METHODSIMRT websites were identified by reviewing the first 50 uniform resource locators on 5 search engines using the search terms IMRT and intensity modulated radiation therapy. Each site was evaluated by three observers for informational content, presentation, accuracy, and balance. A score of low, moderate, or high was assigned to each category based on a predefined scoring system. An overall score was assigned to each site, ranging from −35 to 100 points.RESULTSSeventy‐seven patient‐oriented IMRT websites were identified (45% private, 21% academic, and 18% commercial). Most sites (58%) had a low level of informational content, with information on fundamental aspects of IMRT planning (target delineation and inverse planning) appearing on < 50% of sites. The most commonly discussed tumors were genitourinary (65%) and head and neck (53%) lesions. Few sites, however, described the potential benefits of IMRT (toxicity and tumor control). Most sites (82%) used patient‐appropriate language. False and/or misleading information was seen on 42% of sites and was equally common on academic, private, and commercial sites. Balance statements were present on 24% of sites (most of which were commercial). The median overall score was 20 points (range, −25 to 70 points). The median overall scores for academic, private, commercial, and other sites were 10, 20, 25, and 20 points, respectively (P = 0.26).CONCLUSIONSIn general, the content and quality of patient‐oriented information regarding IMRT on the Internet were poor. Patients and their physicians need to be aware of these problems when selecting treatment courses. Cancer 2004. © 2004 American Cancer Society.

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confidence: 99%

Intensity‐modulated radiotherapy and the Internet

Schomas

Milano

Roeske

et al. 2004

Cancer

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“…A rapid dose falloff at the prescribed dose allows to reduce risks of complications (25) . A vertical falloff at the prescribed dose constitutes an ideal target DVH.…”

Section: Resultsmentioning

confidence: 99%

On correlations in IMRT planning aims

Roy

Das

Nohadani

2016

J Applied Clin Med Phys

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The purpose was to study correlations amongst IMRT DVH evaluation points and how their relaxation impacts the overall plan. 100 head‐and‐neck cancer cases, using the Eclipse treatment planning system with the same protocol, are statistically analyzed for PTV, brainstem, and spinal cord. To measure variations amongst the plans, we use (i) interquartile range (IQR) of volume as a function of dose, (ii) interquartile range of dose as a function of volume, and (iii) dose falloff. To determine correlations for institutional and ICRU goals, conditional probabilities and medians are computed. We observe that most plans exceed the median PTV dose (average normalD50 = 104% prescribed dose). Furthermore, satisfying normalD50 reduced the probability of also satisfying normalD98, constituting a negative correlation of these goals. On the other hand, satisfying normalD50 increased the probability of satisfying normalD2, suggesting a positive correlation. A positive correlation is also observed between the PTV normalV105 and normalV110. Similarly, a positive correlation between the brainstem normalV45 and normalV50 is measured by an increase in the conditional median of normalV45, when normalV50 is violated. Despite the imposed institutional and international recommendations, significant variations amongst DVH points can occur. Even though DVH aims are evaluated independently, sizable correlations amongst them are possible, indicating that some goals cannot be satisfied concurrently, calling for unbiased plan criteria.PACS number(s): 87.55.dk, 87.53.Bn, 87.55.Qr, 87.55.de.

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“…The safety and efficacy of IMRT in benign/low-grade meningiomas has now been firmly established by several prospective clinical outcome studies (Table 4) [23][24][25][26][27][28]. Most series report excellent disease outcomes at 3-5 years with Kaplan-Meier estimates of local control and/or PFS well over 90% and acceptable significant late toxicity (around 5%).…”

Section: Discussionmentioning

confidence: 97%