Combined stereotactic biopsy and stepping-source interstitial irradiation of glioblastoma multiforme
Patients diagnosed with glioblastoma multiforme receiving stereotactic biopsy only either due to tumor localization or impaired clinical status face a devastating prognosis with very short survival times. One strategy to provide an initial cytoreductive and palliative therapy at the time of the ster...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2018
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| In: |
The journal of neurosurgical sciences
Year: 2018, Volume: 62, Issue: 2, Pages: 214-220 |
| ISSN: | 1827-1855 |
| DOI: | 10.23736/S0390-5616.16.03547-X |
| Online Access: | Verlag, Volltext: https://doi.org/10.23736/S0390-5616.16.03547-X Verlag, Volltext: https://www.minervamedica.it/en/journals/neurosurgical-sciences/article.php?cod=R38Y2018N02A0214 
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| Author Notes: | Stefanie Brehmer, Christian V. Guthier, Sven Clausen, Frank Schneider, Dirk-Michael Schulte, Matthias Benker, Frederic Bludau, Gerhard Glatting, Alexander Marx, Peter Schmiedek, Jürgen Hesser, Frederik Wenz, Frank A. Giordano |
| Summary: | Patients diagnosed with glioblastoma multiforme receiving stereotactic biopsy only either due to tumor localization or impaired clinical status face a devastating prognosis with very short survival times. One strategy to provide an initial cytoreductive and palliative therapy at the time of the stereotactic biopsy is interstitial irradiation through the pre-defined trajectory of the biopsy channel. We designed a novel treatment planning system and evaluated the treatment potential of a fixed-source and a stepping-source algorithm for interstitial radiosurgery on non-spherical glioblastoma in direct adjacency to risk structures. Using both setups, we show that radiation doses delivered to 100% of the gross tumor volume shifts from sub-therapeutic (10-12 Gy) to sterilizing single doses (25-30 Gy) when using the stepping source algorithm due to improved sparing of organs-at-risk. Specifically, the maximum doses at the brain stem were 100% of the PTV dose when a fixed central source and 38% when a stepping-source algorithm was used. We also demonstrated precision of intracranial target points and stability of superficial and deep trajectories using both a phantom and a body donor study. Our setup now for the first time provides a basis for a clinical proof-of-concept trial and may widen palliation options for patients with limited life expectancy that should not undergo time-consuming therapies. |
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| Item Description: | Article first published online: January 15, 2016 Gesehen am 06.08.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1827-1855 |
| DOI: | 10.23736/S0390-5616.16.03547-X |