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Impact of Tumour Cell Infiltration on Treatment Outcome in Gamma Knife Radiosurgery: A Modelling Study
Stockholm Univ, Dept Phys, Med Radiat Phys, Stockholm, Sweden..
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH).
Stockholm Univ, Dept Phys, Med Radiat Phys, Stockholm, Sweden..
Karolinska Univ Hosp, Dept Med Phys, Stockholm, Sweden..
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2019 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 39, no 4, p. 1675-1687Article in journal (Refereed) Published
Abstract [en]

Background: High-grade gliomas with a widespread infiltration beyond the lesion detectable on diagnostic images are increasingly treated with Gamma Knife (TM) Radiosurgery (GKRS). The aim of this study was to assess the cell infiltration impact on the GKRS outcome for invasive gliomas. Materials and Methods: Tumor cell distribution was predicted using a novel algorithm whose computations are iterated until they reach an agreement with histopathology results. Treatment plans with different combinations of dose prescription (20 Gy at 50%-20% isodose) and targets [Gross Tumour Volume (GTV), zone 1 with 100%-60% of the GTV cell density and zone 2 with 60%-0% of the GTV cell density] were evaluated using standard conformity indexes (CI) and radiobiological parameters. Results: Considerable differences in terms of tumor control probability were found between plans having similar CI but different targets. Conclusion: To account for tumor cell infiltration outside the target is of key importance in GKRS and a radiobiological evaluation should accompany well-established CI.

Place, publisher, year, edition, pages
INT INST ANTICANCER RESEARCH , 2019. Vol. 39, no 4, p. 1675-1687
Keywords [en]
Gamma Knife, tumor cell infiltration, modelling, glioma
National Category
Basic Medicine
Identifiers
URN: urn:nbn:se:kth:diva-251215DOI: 10.21873/anticanres.13273ISI: 000463619600005PubMedID: 30952706Scopus ID: 2-s2.0-85064526133OAI: oai:DiVA.org:kth-251215DiVA, id: diva2:1317916
Note

QC 20190524

Available from: 2019-05-24 Created: 2019-05-24 Last updated: 2019-05-24Bibliographically approved

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Khazraei Manesh, Zohreh

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