Reirradiation of glioblastoma through the use of a reduced dose rate on a tomotherapy unit.

Technology in Cancer Research & Treatment
Karl H RasmussenWolfgang A Tomé

Abstract

Pulsed Reduced Dose Rate (PRDR) is a method of irradiation designed to minimize radiation-related toxicities in patients undergoing reirradiation for loco-regional reoccurrence of glioblastoma. PRDR delivers a standard 2 Gy fraction delivered on a conventional medical linear accelerator using conventional 3D conformal beam arrangements. To reduce the likelihood of normal tissue complications, radiation is delivered over ten 0.2 Gy sub-fractions with a 3 minute time interval between subfractions to give a maximal time averaged dose rate of 4 Gy/hr. However, a TomoTherapy unit has a fixed output rate of 8 Gy/min. If the dose per fraction is conventionally planned at less than 0.6 Gy/fraction, the result is a clinically unacceptable treatment plan. The method described in this paper involves a virtual grid style blocking scheme, where half of the beam angles are directionally blocked using 15 equally spaced segments surrounding the center of the image set. Ten patients treated using conventional PRDR with an average PTV volume of 353.3 ml were retrospectively re-planned using five techniques (standard 2 Gy fraction, 2 Gy in ten 0.2 Gy fractions without grid blocking, two grid patterns, and a combination plan incorporating both gri...Continue Reading

References

Feb 1, 1997·International Journal of Radiation Oncology, Biology, Physics·A van't RietW van der Zee
Dec 20, 2003·Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists·Maria F ChanC Clifton Ling
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Aug 21, 2007·International Journal of Radiation Oncology, Biology, Physics·Daliang CaoDavid M Shepard

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Citations

Mar 1, 2012·Der Radiologe·J Boda-HeggemannF Lohr
Aug 12, 2016·International Journal of Radiation Oncology, Biology, Physics·Kurt MeyerBrian Marples
Apr 27, 2011·Technology in Cancer Research & Treatment·J A TorokS A Burton
Feb 23, 2021·Neuro-oncology·Peter Mathen, DeeDee K Smart

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