Peer-reviewed veterinary case report
Optimizing radiation therapy for brainstem tumors in dogs
By Meier, Valeria et al.·Published in Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association·2020·Small Animal Department·View original on PubMed →
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Original publication title: Using biologically based objectives to optimize boost intensity-modulated radiation therapy planning for brainstem tumors in dogs.
- Species:
- dog
Plain-English summary
A group of dogs with brainstem tumors underwent a new type of radiation therapy called simultaneously-integrated boost intensity-modulated radiation therapy (SIB-IMRT) to improve treatment effectiveness while minimizing side effects. This approach aimed to deliver higher doses to the tumor while keeping the risk of damage to surrounding healthy tissue low. In 80% of the dogs treated, the risk of complications from the radiation was estimated to be under 10%. This method showed promise in safely escalating the dose to better control the tumors, especially in smaller tumors.
People also search for: dog brain tumor treatment · radiation therapy for dogs · brainstem tumor in dogs · side effects of dog radiation therapy
Abstract
Irradiated brain tumors commonly progress at the primary site, generating interest in focal dose escalation. The aim of this retrospective observational study was to use biological optimization objectives for a modeling exercise with simultaneously-integrated boost IMRT (SIB-IMRT) to generate a dose-escalated protocol with acceptable late radiation toxicity risk estimate and improve tumor control for brainstem tumors in dogs safely. We re-planned 20 dog brainstem tumor datasets with SIB-IMRT, prescribing 20 × 2.81 Gy to the gross tumor volume (GTV) and 20 × 2.5 Gy to the planning target volume. During the optimization process, we used biologically equivalent generalized equivalent uniform doses (gEUD) as planning aids. These were derived from human data, calculated to adhere to normal tissue complication probability (NTCP) ≤5%, and converted to the herein used fractionation schedule. We extracted the absolute organ at risk dose-volume histograms to calculate NTCP of each individual plan. For planning optimization, gEUD= 39.8 Gy for brain and gEUD= 43.8 Gy for brainstem were applied. Mean brain NTCP was low with 0.43% (SD ±0.49%, range 0.01-2.04%); mean brainstem NTCP was higher with 7.18% (SD ±4.29%, range 2.87-20.72%). Nevertheless, NTCP of < 10% in brainstem was achievable in 80% (16/20) of dogs. Spearman's correlation between relative GTV and NTCP was high (ρ = 0.798, P < .001), emphasizing increased risk with relative size even with subvolume-boost. Including biologically based gEUD values into optimization allowed estimating NTCP during the planning process. In conclusion, gEUD-based SIB-IMRT planning resulted in dose-escalated treatment plans with acceptable risk estimate of NTCP < 10% in the majority of dogs with brainstem tumors. Risk was correlated with relative tumor size.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31600027/