Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses
Yıl: 2019 Cilt: 20 Sayı: 1 Sayfa Aralığı: 49 - 53 Metin Dili: İngilizce DOI: 10.4274/imj.galenos.2018.79926 İndeks Tarihi: 14-04-2020
Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses
Öz: Introduction: The aim of the study is to reveal the changingtrends in radiotherapy (RT) for glioblastoma multiforme (GBM)from past to present and to show the changes in organs at risk(OARs) doses.Methods: We re-planned 10 GBM patients who werepreviously irradiated. Rigid fusion was performed throughpre- and postoperative magnetic resonance imaging (MRI) andsimulation computed tomography, and 9 separate volumes werecreated. While volumes varied from whole brain RT (WBRT) topostoperative two-phase irradiation, RT application ranged from2-dimensional Co-60 treatment to 3-dimensional volumetricmodulated arc therapy (VMAT). OARs were contoured, and doseswere noted. A 3 dimensional-conformal RT (3D-CRT) plan of thevolume created by preoperative MRI was compared to 3D-CRTand VMAT plans generated by postoperative MRI. Statisticalanalysis was performed using Paired sample t-test.Results: During the time of WBRT, normal brain tissue wasreceiving 45-60 Gy. Through VMAT, the median brain-planningtarget volume (PTV) Dmean decreased to 35 Gy. According to bothPTV-Radiation Therapy Oncology Group (RTOG)preop and PTVRTOGpreop3D-CRT plannings, there was no difference in all OARsdoses between plans, including brain-PTV initial volume Dmeanand brain-PTV boost Dmean doses. Significantly lower OARs doseswere obtained from 3D-CRT plans based on both PTV-RTOGpreopand PTV-RTOGpostop volumes with the VMAT planning.Conclusion: With changing trends in RT for GBM, there hasbeen a significant decrease in treatment volumes and normaltissue doses. According to the postoperative volume definition ofRTOG, lower normal tissue doses are obtained from VMAT plans,compared to the conformal treatment plans.
Anahtar Kelime: Konular:
Glioblastoma Multiforme Radyoterapisinde Değişen Eğilimler ve Normal Doku Dozlarina Etkileri
Öz: Amaç: Çalışmanın amacı glioblastoma multiforme (GBM) radyoterapisindeki (RT) geçmişten günümüze değişen eğilimlerin ortaya konulması ve risk altındaki organ dozlarındaki değişimin gösterilmesidir. Yöntemler: GBM tanısı ile postopereatif temozolamid ve RT ile tedavi edilen 10 hastanın simülasyon bilgisayarlı tomografi görüntüleri retrospektif olarak incelenerek pre- ve postoperatif manyetik rezonans görüntüleri (MRG) ile rjiid füzyon yapıldı ve 9 ayrı volüm oluşturuldu. Volümler total kranyum ışınlamadan postoperatif iki fazlı ışınlamaya değişkenlik gösterirken, RT uygulaması 2-boyutlu (2B) Co-60 tedavisinden 3-boyutlu (3B) volumetrik ark tedaviye (VMAT) değişiyordu. Risk altındaki organlar (organs at risk - OAR) konturlandı. Beyin-hedef hacmi planlama (PTV) Dmean, beyin sapı Dmax, göz Dmax ipsilateral/ kontralateral, kiazma Dmax, koklea Dmean ipsilateal/kontralateral, lakrimal gland Dmax ipsilateral/konrtalateral, lens Dmax ipsilateral/ kontralateral, pituiter gland Dmax dozları kaydedildi. 7, 8, 9. planlar (preop MRG’den oluşturulan volümün 3B-konformal RT- 3B-KRT planı ile postop MRG’den oluşturulan 3B-KRT ve VMAT planları) karşılaştırıldı. Paired sample t-testi ile istatistiksel analiz yapıldı. Bulgular: Total kranyum RT uygulandığı dönemlerde normal beyin dokusunun hepsi 45-60 Gy alırken VMAT ile beyin-PTV Dmean medyan 35 Gy’e düşmüştür. Aynı zamanda göz ve lensler dışında risk altındaki organlar verilen tüm dozu alarak 60 Gy uygulanan gruplarda doz sınırlamaları aşılmıştır. Hem PTV-Radyasyon Terapisi Onkoloji Grubu (RTOG)preop hem de PTV-RTOGpostop 3D-CRT planına göre beyin-PTVinitial volüm Dmean ve beyin-PTVboost Dmean dozları dahil olmak üzere tüm OAR dozlarında iki plan arasında istatistiksel anlamlı fark yoktu. VMAT planı ile hem PTVRTOGpreop hem de PTV RTOGpostop volümlerine göre yapılan 3D-CRT planlarından istatistiksel anlamlı daha düşük OAR dozları elde edildi. Sonuç: Tarihsel süreçte ışınlanan volüm ve normal doku dozlarında belirgin azalma olmuştur. RTOG’nin postoperatif volüm tanımına göre konformal ve VMAT planları karşılaştırıldığında VMAT planlamada daha düşük normal doku dozları elde edilmektedir.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | İBİŞ K, KOKSAL C, AKBAŞ U, ALTUN M (2019). Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. , 49 - 53. 10.4274/imj.galenos.2018.79926 |
| Chicago | İBİŞ Kamuran,KOKSAL CANAN,AKBAŞ Uğur,ALTUN MUSA Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. (2019): 49 - 53. 10.4274/imj.galenos.2018.79926 |
| MLA | İBİŞ Kamuran,KOKSAL CANAN,AKBAŞ Uğur,ALTUN MUSA Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. , 2019, ss.49 - 53. 10.4274/imj.galenos.2018.79926 |
| AMA | İBİŞ K,KOKSAL C,AKBAŞ U,ALTUN M Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. . 2019; 49 - 53. 10.4274/imj.galenos.2018.79926 |
| Vancouver | İBİŞ K,KOKSAL C,AKBAŞ U,ALTUN M Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. . 2019; 49 - 53. 10.4274/imj.galenos.2018.79926 |
| IEEE | İBİŞ K,KOKSAL C,AKBAŞ U,ALTUN M "Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses." , ss.49 - 53, 2019. 10.4274/imj.galenos.2018.79926 |
| ISNAD | İBİŞ, Kamuran vd. "Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses". (2019), 49-53. https://doi.org/10.4274/imj.galenos.2018.79926 |
| APA | İBİŞ K, KOKSAL C, AKBAŞ U, ALTUN M (2019). Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. İstanbul Medical Journal, 20(1), 49 - 53. 10.4274/imj.galenos.2018.79926 |
| Chicago | İBİŞ Kamuran,KOKSAL CANAN,AKBAŞ Uğur,ALTUN MUSA Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. İstanbul Medical Journal 20, no.1 (2019): 49 - 53. 10.4274/imj.galenos.2018.79926 |
| MLA | İBİŞ Kamuran,KOKSAL CANAN,AKBAŞ Uğur,ALTUN MUSA Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. İstanbul Medical Journal, vol.20, no.1, 2019, ss.49 - 53. 10.4274/imj.galenos.2018.79926 |
| AMA | İBİŞ K,KOKSAL C,AKBAŞ U,ALTUN M Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. İstanbul Medical Journal. 2019; 20(1): 49 - 53. 10.4274/imj.galenos.2018.79926 |
| Vancouver | İBİŞ K,KOKSAL C,AKBAŞ U,ALTUN M Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses. İstanbul Medical Journal. 2019; 20(1): 49 - 53. 10.4274/imj.galenos.2018.79926 |
| IEEE | İBİŞ K,KOKSAL C,AKBAŞ U,ALTUN M "Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses." İstanbul Medical Journal, 20, ss.49 - 53, 2019. 10.4274/imj.galenos.2018.79926 |
| ISNAD | İBİŞ, Kamuran vd. "Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses". İstanbul Medical Journal 20/1 (2019), 49-53. https://doi.org/10.4274/imj.galenos.2018.79926 |
