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. 2022 Apr 25;11(9):2413.
doi: 10.3390/jcm11092413.

To Optimize Radiotherapeutic Plans for Superior Tumor Coverage Predicts Malignant Glioma Prognosis and Normal Tissue Complication Probability

Chun-Yuan Kuo  1   2 , Wei-Hsiu Liu  3   4 , Yu-Ching Chou  5 , Ming-Hsien Li  1 , Jo-Ting Tsai  1   6 , David Yc Huang  7 , Jang-Chun Lin  1   6
Affiliations

To Optimize Radiotherapeutic Plans for Superior Tumor Coverage Predicts Malignant Glioma Prognosis and Normal Tissue Complication Probability

Chun-Yuan Kuo et al. J Clin Med. .

Abstract

Background: Radiotherapy (RT) provides a modern treatment to enhance the malignant glioma control rate. The purpose of our study was to determine the effect of tumor coverage on disease prognosis and to predict optimal RT plans to achieve a lower normal tissue complication probability (NTCP). Methods: Ten malignant-glioma patients with tumors adjacent to organs at risk (OARs) were collected. The patients were divided into two groups according to adequate coverage or not, and prognosis was analyzed. Then, using intensity-modulated radiation therapy (IMRT), volume-modulated arc therapy (VMAT), and helical tomotherapy (TOMO) to simulate new treatment plans for 10 patients, the advantages of these planning systems were revealed for subsequent prediction of NTCP. Results: The results of clinical analysis indicated that overall survival (p = 0.078) between the adequate and inadequate groups showed no differences, while the adequate group had better recurrence-free survival (p = 0.018) and progression-free survival (p = 0.009). TOMO had better CI (p < 0.001) and also predicted a lower total-irradiated dose to the normal brain (p = 0.001) and a lower NTCP (p = 0.027). Conclusions: The TOMO system provided optimal therapeutic planning, reducing NTCP and achieving better coverage. Combined with the clinical results, our findings suggest that TOMO can make malignant glioma patients close to OARs achieve better disease control.

Keywords: IMRT; NTCP; TOMO; VMAT; malignant glioma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier overall survival by adequate group compared with inadequate (p = 0.078).
Figure 2
Figure 2
(a) Recurrence-free survival for comparing adequate with inadequate group (p = 0.018); (b) progression-free survival for comparing adequate with inadequate group (p = 0.009).
Figure 3
Figure 3
The 4th patient’s dose distributions on IMRT, VMAT, and TOMO. Color-wash areas: 46.00 Gy (pink), 41.40 Gy (yellow). IMRT: intensity-modulated radiation therapy; VMAT: volumetric-modulated arc therapy; TOMO: helical tomotherapy.
See this image and copyright information in PMC

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References

    1. Ostrom Q.T., Gittleman H., Liao P., Rouse C., Chen Y., Dowling J., Wolinsky Y., Kruchko C., Barnholtz-Sloan J. Cbtrus statistical report: Primary brain and central nervous system tumors diagnosed in the united states in 2007–2011. Neuro-Oncology. 2014;16((Suppl. 4)):iv1–iv63. doi: 10.1093/neuonc/nou223. - DOI - PMC - PubMed
    1. Brandes A.A., Tosoni A., Franceschi E., Sotti G., Frezza G., Amistà P., Morandi L., Spagnolli F., Ermani M. Recurrence pattern after temozolomide concomitant with and adjuvant to radiotherapy in newly diagnosed patients with glioblastoma: Correlation with mgmt promoter methylation status. J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol. 2009;27:1275–1279. doi: 10.1200/JCO.2008.19.4969. - DOI - PubMed
    1. Milano M.T., Okunieff P., Donatello R.S., Mohile N.A., Sul J., Walter K.A., Korones D.N. Patterns and timing of recurrence after temozolomide-based chemoradiation for glioblastoma. Int. J. Radiat. Oncol. Biol. Phys. 2010;78:1147–1155. doi: 10.1016/j.ijrobp.2009.09.018. - DOI - PubMed
    1. McDonald M.W., Shu H.K., Curran W.J., Jr., Crocker I.R. Pattern of failure after limited margin radiotherapy and temozolomide for glioblastoma. Int. J. Radiat. Oncol. Biol. Phys. 2011;79:130–136. doi: 10.1016/j.ijrobp.2009.10.048. - DOI - PubMed
    1. Pan H., Alksne J., Mundt A.J., Murphy K.T., Cornell M., Kesari S., Lawson J.D. Patterns of imaging failures in glioblastoma patients treated with chemoradiation: A retrospective study. Med. Oncol. 2012;29:2040–2045. doi: 10.1007/s12032-011-0116-5. - DOI - PubMed

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