Dosimetric comparison of hippocampal-sparing technologies in patients with low-grade glioma.

IF 3.7 Q1 CLINICAL NEUROLOGY Neuro-oncology advances Pub Date : 2024-08-06 eCollection Date: 2024-01-01 DOI:10.1093/noajnl/vdae131
Aoife Williamson, Peter Houston, Jennifer Paterson, Anthony J Chalmers, Philip McLoone, Natasha Fullerton, Sin Yee Foo, Allan James, Stefan Nowicki
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Abstract

Background: Radiotherapy (RT) plays an integral role in the management of low-grade gliomas (LGG). Late toxicity from RT can cause progressive neurocognitive dysfunction. Radiation-induced damage to the hippocampus (HCP) plays a considerable role in memory decline. Advancements in photon planning software have resulted in the development of multi-criteria optimization (MCO) and HyperArc technologies which may improve HCP sparing while maintaining planning target volume (PTV) target coverage.

Methods: Three planning methods for hippocampal sparing (HS) were compared, volumetric modulated arc therapy (VMAT) without HS (VMAT_noHS), VMAT with HS (VMAT_HS), MCO with HS (MCO_HS), and HyperArc with HS (HyperArc_HS).

Results: Twenty-five patients were identified. The contralateral HCP was spared in 16 patients and bilateral HCP in 9 patients with superiorly located tumors. All 3 HS planning techniques showed significant reductions in dose to the spared HCP in contralateral cases but only VMAT_HS and MCO_HS achieved this in bilateral cases (P < .008). Only MCO_HS was superior to VMAT_HS in lowering the dose to both contralateral HCP and bilateral HCP in all measured metrics (P < .008). PTV and OAR (organ at risk) dose constraints were achieved for all plans.

Conclusions: This retrospective dosimetric study demonstrated the feasibility of HS for low-grade glioma. All 3 HS planning techniques achieved significant dose reductions to the spared contralateral hippocampus, but only MCO_HS and VMAT_HS achieved this in bilateral cases. MCO was superior to other planning techniques for sparing both bilateral and contralateral hippocampi.

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低级别胶质瘤患者海马区保留技术的剂量学比较。
背景:放疗(RT)在低级别胶质瘤(LGG)的治疗中发挥着不可或缺的作用。放疗的晚期毒性可导致进行性神经认知功能障碍。辐射引起的海马体(HCP)损伤在记忆力衰退中起着重要作用。光子计划软件的进步导致了多标准优化(MCO)和HyperArc技术的发展,这些技术可以在保持计划靶体积(PTV)目标覆盖范围的同时,改善对海马体的保护:方法:比较了海马区疏松(HS)的三种规划方法:不含 HS 的容积调制弧治疗(VMAT)(VMAT_noHS)、含 HS 的 VMAT(VMAT_HS)、含 HS 的 MCO(MCO_HS)和含 HS 的 HyperArc(HyperArc_HS):结果:共发现 25 例患者。结果:确定了 25 名患者,其中 16 名患者的对侧 HCP 不受影响,9 名肿瘤位于上部的患者的双侧 HCP 不受影响。在对侧病例中,所有 3 种 HS 计划技术都能显著减少幸免的 HCP 的剂量,但在双侧病例中,只有 VMAT_HS 和 MCO_HS 实现了这一目标(P P 结论:这项回顾性剂量学研究证明了 HS 治疗低级别胶质瘤的可行性。所有 3 种 HS 计划技术都能显著减少幸免的对侧海马的剂量,但只有 MCO_HS 和 VMAT_HS 在双侧病例中实现了这一目标。在保留双侧和对侧海马方面,MCO优于其他规划技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
6.20
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12 weeks
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