PMID- 21546744
OWN - NLM
STAT- MEDLINE
DCOM- 20110915
LR  - 20191210
IS  - 1998-4138 (Electronic)
IS  - 1998-4138 (Linking)
VI  - 7
IP  - 1
DP  - 2011 Jan-Mar
TI  - Intensity-modulated radiation to spare neural stem cells in brain tumors: a 
      computational platform for evaluation of physical and biological dose metrics.
PG  - 58-63
LID - 10.4103/0973-1482.80463 [doi]
AB  - BACKGROUND: Neurocognitive effects following whole-brain and partial-brain 
      irradiation can cause considerable morbidity. Sparing of neural stem cells (NSCs) 
      is proposed as an avenue for reducing the long-term radiation-induced defects in 
      learning, memory, and intelligence. We performed an analytical study to spare the 
      NSC from partial-brain irradiation by intensity-modulated radiotherapy (IMRT). 
      OBJECTIVE: The aim of this study is to achieve maximal sparing of NSC during 
      irradiation of brain tumors using biologically equivalent dose (BED) for all 
      plans. The consequent clinical benefit will possibly be in terms of acute effects 
      on stem cells and delayed neurologic sequelae to brain. A tool to modulate 
      various physical and biological dose metrics has been used to study the 
      optimization of radiation therapy for brain tumors with constraints imposed on 
      total radiation to NSC. MATERIALS AND METHODS: A total of 10 successive patients 
      of grade III and IV gliomas of brain, who underwent total or near total excision 
      of brain tumors, were included in the study. Patients underwent computed 
      tomography and magnetic resonance imaging fusion for contouring. Computational 
      codes used to analyze the efficacy of the plan are quality of coverage, 
      homogeneity index, and conformity index. Wide range of radiosensitivity 
      parameters were evaluated by using equivalent uniform dose and tumor control 
      probability (TCP) to predict tumor control with and without sparing of NSC. 
      RESULTS: The physical and biological dose metrics were modulated by fitting 
      standard deviation of 0.3% for all plans. The maximum NSC sparing was achieved in 
      IMRT plans with constraints applied to local TCP. Similarly, for BED of plans 
      with and without constraints, the estimated mean reduction in acute complications 
      of NSC achieved was 12.23% (range, 4.27-28.33%). The estimated mean reduction in 
      BED for late complications of late-reacting brain tissue is 14.69% (range, 
      7.39-33.56%).
FAU - Jaganathan, Arun
AU  - Jaganathan A
AD  - Department of Advanced Centre for Radiation Oncology, Dr Balabhai Nanavati 
      Hospital, Mumbai 400 056, Maharashtra, India. arunradphy@gmail.com
FAU - Tiwari, Meena
AU  - Tiwari M
FAU - Phansekar, Rahul
AU  - Phansekar R
FAU - Panta, Rajkumar
AU  - Panta R
FAU - Huilgol, Nagraj
AU  - Huilgol N
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - India
TA  - J Cancer Res Ther
JT  - Journal of cancer research and therapeutics
JID - 101249598
SB  - IM
MH  - Brain Neoplasms/diagnostic imaging/*radiotherapy
MH  - *Computer Simulation
MH  - Dose-Response Relationship, Radiation
MH  - Humans
MH  - Neural Stem Cells/*radiation effects
MH  - Radiation Injuries/*prevention & control
MH  - Radiography
MH  - *Radiotherapy Planning, Computer-Assisted
MH  - *Radiotherapy, Intensity-Modulated
EDAT- 2011/05/07 06:00
MHDA- 2011/09/16 06:00
CRDT- 2011/05/07 06:00
PHST- 2011/05/07 06:00 [entrez]
PHST- 2011/05/07 06:00 [pubmed]
PHST- 2011/09/16 06:00 [medline]
AID - JCanResTher_2011_7_1_58_80463 [pii]
AID - 10.4103/0973-1482.80463 [doi]
PST - ppublish
SO  - J Cancer Res Ther. 2011 Jan-Mar;7(1):58-63. doi: 10.4103/0973-1482.80463.