Sparing of the hippocampus, limbic circuit and neural stem cell compartment during partial brain radiotherapy for glioma: A dosimetric feasibility study
Sparing of the hippocampus, limbic circuit and neural stem cell compartment during partial brain radiotherapy for glioma: A dosimetric feasibility study
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DOI：
10.1111/j.1754-9485.2011.02282.x
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发表时间：
2011-08-01
影响因子：
1.6
通讯作者：
Turian, Julius V.
中科院分区：
文献类型：
--
作者：
Marsh, James C.;Godbole, Rohit;Turian, Julius V.
简介：本研究的目的是评估部分脑放疗（PBRT）过程中保留对侧或双侧神经干细胞（NSC）隔室、海马和边缘回路的可行性。方法和材料：治疗计划为5例半球高级别胶质瘤、5例半球低级别胶质瘤和2例脑干胶质瘤（12例）制定。对于每一个，标准的调强放射治疗（IMRT）计划，以及IMRT计划，保留对侧（半球病例）或双侧（脑干病例）边缘回路，海马和NSC。针对边缘回路、海马和NSC生成迟发效应的生物等效剂量（BEDlate（effects））。计算每个计划的平均物理剂量和床当量的相对减少百分比结果：我们能够将这些关键结构的物理剂量和BEDlate效应分别减少23.5-56.8%和23.6- 66%。对于高级别和低级别胶质瘤，在PBRT过程中使用IMRT可以保留对侧边缘回路、NSC和海马，并且在脑干低级别胶质瘤的PBRT期间保留双侧海马。这种方法可以减少颅脑放射治疗的晚期认知后遗症。
Introduction: The aim of this study was to assess the feasibility of sparing contralateral or bilateral neural stem cell (NSC) compartment, hippocampus and limbic circuit during partial brain radiotherapy (PBRT).Methods and materials: Treatment plans were generated for five hemispheric high-grade gliomas, five hemispheric low-grade gliomas and two brainstem gliomas (12 patients). For each, standard intensity-modulated radiotherapy (IMRT) plans were generated, as well as IMRT plans which spared contralateral (hemispheric cases) or bilateral (brainstem cases) limbic circuit, hippocampus, and NSC. Biologically equivalent dose for late effects (BEDlate (effects)) was generated for limbic circuit, hippocampus and NSC. Per cent relative reduction in mean physical dose and BED was calculated for each plan (standard vs. sparing).Results: We were able to reduce physical dose and BEDlate effects to these critical structures by 23.5-56.8% and 23.6-66%, respectively.Conclusion: It is possible to spare contralateral limbic circuit, NSC and hippocampus during PBRT for both high-and low-grade gliomas using IMRT, and to spare the hippocampus bilaterally during PBRT for brainstem low-grade gliomas. This approach may reduce late cognitive sequelae of cranial radiotherapy.