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Title: Tumor histology and location predict deep nuclei toxicity: Implications for late effects from focal brain irradiation

Abstract

Normal tissue toxicity resulting from both disease and treatment is an adverse side effect in the management of patients with central nervous system malignancies. We tested the hypothesis that despite these improvements, certain tumors place patients at risk for neurocognitive, neuroendocrine, and neurosensory late effects. Defining patient groups at risk for these effects could allow for development of preventive strategies. Fifty patients with primary brain tumors underwent radiation planning with magnetic resonance imaging scan and computed tomography datasets. Organs at risk (OAR) responsible for neurocognitive, neuroendocrine, and neurosensory function were defined. Inverse-planned intensity-modulated radiation therapy was optimized with priority given to target coverage while penalties were assigned to exceeding normal tissue tolerances. Tumor laterality, location, and histology were compared with OAR doses, and analysis of variance was performed to determine the significance of any observed correlation. The ipsilateral hippocampus exceeded dose limits in frontal (74%), temporal (94%), and parietal (100%) lobe tumor locations. The contralateral hippocampus was at risk in the following tumor locations: frontal (53%), temporal (83%), or parietal (50%) lobe. Patients with high-grade glioma were at risk for ipsilateral (88%) and contralateral (73%) hippocampal damage (P <0.05 compared with other histologies). The pituitary gland and hypothalamus exceeded dosemore » tolerances in patients with pituitary tumors (both 100%) and high-grade gliomas (50% and 75%, P <0.05 compared with other histologies), respectively. Despite application of modern radiation therapy, certain tumor locations and histologies continue to place patients at risk for morbidity. Patients with high-grade gliomas or tumors located in the frontal, temporal, or parietal lobes are at risk for neurocognitive decline, likely because of larger target volumes and higher radiation doses. Data from this study may help to stratify patients at risk for late effects to develop strategies to reduce frequency and severity of radiation sequelae.« less

Authors:
;  [1]; ;  [1]
  1. Norton Neuroscience Institute, Louisville, KY (United States)
Publication Date:
OSTI Identifier:
22131235
Resource Type:
Journal Article
Journal Name:
Medical Dosimetry
Additional Journal Information:
Journal Volume: 37; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0958-3947
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; COMPUTERIZED TOMOGRAPHY; DATASETS; DOSE LIMITS; DOSIMETRY; GLIOMAS; HEALTH HAZARDS; HIPPOCAMPUS; HISTOLOGY; HYPOTHALAMUS; IRRADIATION; NMR IMAGING; PATIENTS; PITUITARY GLAND; PLANNING; RADIATION DOSES; RADIOTHERAPY; TOXICITY

Citation Formats

Plaga, Alexis, Shields, Lisa B.E., Sun, David A., Vitaz, Todd W., Brain Tumor Center, Norton Healthcare, Louisville, KY, Spalding, Aaron C., E-mail: acspalding1@gmail.com, and Norton Cancer Institute, Radiation Center, Kosair Children's Hospital, Louisville, KY. Tumor histology and location predict deep nuclei toxicity: Implications for late effects from focal brain irradiation. United States: N. p., 2012. Web. doi:10.1016/J.MEDDOS.2011.10.002.
Plaga, Alexis, Shields, Lisa B.E., Sun, David A., Vitaz, Todd W., Brain Tumor Center, Norton Healthcare, Louisville, KY, Spalding, Aaron C., E-mail: acspalding1@gmail.com, & Norton Cancer Institute, Radiation Center, Kosair Children's Hospital, Louisville, KY. Tumor histology and location predict deep nuclei toxicity: Implications for late effects from focal brain irradiation. United States. https://doi.org/10.1016/J.MEDDOS.2011.10.002
Plaga, Alexis, Shields, Lisa B.E., Sun, David A., Vitaz, Todd W., Brain Tumor Center, Norton Healthcare, Louisville, KY, Spalding, Aaron C., E-mail: acspalding1@gmail.com, and Norton Cancer Institute, Radiation Center, Kosair Children's Hospital, Louisville, KY. 2012. "Tumor histology and location predict deep nuclei toxicity: Implications for late effects from focal brain irradiation". United States. https://doi.org/10.1016/J.MEDDOS.2011.10.002.
@article{osti_22131235,
title = {Tumor histology and location predict deep nuclei toxicity: Implications for late effects from focal brain irradiation},
author = {Plaga, Alexis and Shields, Lisa B.E. and Sun, David A. and Vitaz, Todd W. and Brain Tumor Center, Norton Healthcare, Louisville, KY and Spalding, Aaron C., E-mail: acspalding1@gmail.com and Norton Cancer Institute, Radiation Center, Kosair Children's Hospital, Louisville, KY},
abstractNote = {Normal tissue toxicity resulting from both disease and treatment is an adverse side effect in the management of patients with central nervous system malignancies. We tested the hypothesis that despite these improvements, certain tumors place patients at risk for neurocognitive, neuroendocrine, and neurosensory late effects. Defining patient groups at risk for these effects could allow for development of preventive strategies. Fifty patients with primary brain tumors underwent radiation planning with magnetic resonance imaging scan and computed tomography datasets. Organs at risk (OAR) responsible for neurocognitive, neuroendocrine, and neurosensory function were defined. Inverse-planned intensity-modulated radiation therapy was optimized with priority given to target coverage while penalties were assigned to exceeding normal tissue tolerances. Tumor laterality, location, and histology were compared with OAR doses, and analysis of variance was performed to determine the significance of any observed correlation. The ipsilateral hippocampus exceeded dose limits in frontal (74%), temporal (94%), and parietal (100%) lobe tumor locations. The contralateral hippocampus was at risk in the following tumor locations: frontal (53%), temporal (83%), or parietal (50%) lobe. Patients with high-grade glioma were at risk for ipsilateral (88%) and contralateral (73%) hippocampal damage (P <0.05 compared with other histologies). The pituitary gland and hypothalamus exceeded dose tolerances in patients with pituitary tumors (both 100%) and high-grade gliomas (50% and 75%, P <0.05 compared with other histologies), respectively. Despite application of modern radiation therapy, certain tumor locations and histologies continue to place patients at risk for morbidity. Patients with high-grade gliomas or tumors located in the frontal, temporal, or parietal lobes are at risk for neurocognitive decline, likely because of larger target volumes and higher radiation doses. Data from this study may help to stratify patients at risk for late effects to develop strategies to reduce frequency and severity of radiation sequelae.},
doi = {10.1016/J.MEDDOS.2011.10.002},
url = {https://www.osti.gov/biblio/22131235}, journal = {Medical Dosimetry},
issn = {0958-3947},
number = 3,
volume = 37,
place = {United States},
year = {Mon Oct 01 00:00:00 EDT 2012},
month = {Mon Oct 01 00:00:00 EDT 2012}
}