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• W2034106903 abstract "Purpose/Objective(s)HFSRT for patients with GBM allows treatment to be condensed over a very short time while still delivering a dose comparable to that of standard fractionation. Using NTCP modeling, we evaluated 4 schedules of dose escalation using dose painting HFSRT in patients with STR newly diagnosed GBM with regard to radiation toxicities.Materials/MethodsTen patients who underwent STR for newly diagnosed GBM and received standard radiation therapy as per Stupp et al were retrospectively identified. We calculated equivalent BED plans using α/β = 7 (Steel et al) for dose painted HFSRT delivered over 5 fractions as the baseline reference for comparison of toxicities: 5x7.5 Gy to the contrast-enhancing tumor cavity and residual enhancing tumor and 5x6 Gy to FLAIR. A 5mm margin on the cavity and residual enhancing tumor was used to create CTV1. A 2cm margin on the FLAIR was used to create the CTV2. Dose-escalation was confined to the area of gross residual disease with a 3mm margin to create CTV3. A 5mm expansion was used to create all three PTVs. NTCP values were computed using standard models and toxicities calculated for brain and brainstem (necrosis/infarction) and chiasm (blindness) for 4 schedules of dose-escalation - 5x8.5 Gy, 5x9 Gy, 5x9.5 Gy, and 5x10 Gy - compared to 5x7.5 Gy reference plan.ResultsThe Table lists median NTCP risks of increased toxicities (see below). There was no significant risk of increased toxicity to the brainstem or chiasm for any schedule of dose-escalation, compared to baseline (p > 0.48). Although there was a significant risk of increased toxicity to the brain for 5x9.5 Gy (p < 0.02) and 5x10 Gy schedules (p < 0.02), the risk was not significant for 5x8.5 Gy (p > 0.27) and 5x9 Gy schedules (p > 0.17).ConclusionsPoster Viewing Abstract 2142; TableNTCP median risks of increased toxicities for each organ based on dose-escalation schedulesSchedulesBrainBrainstemChiasm5x8.5 Gy0.0330.0060.0345x9 Gy0.0760.0150.0095x9.5 Gy0.1110.0280.0055x10 Gy0.1450.0650.078 Open table in a new tab Purpose/Objective(s)HFSRT for patients with GBM allows treatment to be condensed over a very short time while still delivering a dose comparable to that of standard fractionation. Using NTCP modeling, we evaluated 4 schedules of dose escalation using dose painting HFSRT in patients with STR newly diagnosed GBM with regard to radiation toxicities. HFSRT for patients with GBM allows treatment to be condensed over a very short time while still delivering a dose comparable to that of standard fractionation. Using NTCP modeling, we evaluated 4 schedules of dose escalation using dose painting HFSRT in patients with STR newly diagnosed GBM with regard to radiation toxicities. Materials/MethodsTen patients who underwent STR for newly diagnosed GBM and received standard radiation therapy as per Stupp et al were retrospectively identified. We calculated equivalent BED plans using α/β = 7 (Steel et al) for dose painted HFSRT delivered over 5 fractions as the baseline reference for comparison of toxicities: 5x7.5 Gy to the contrast-enhancing tumor cavity and residual enhancing tumor and 5x6 Gy to FLAIR. A 5mm margin on the cavity and residual enhancing tumor was used to create CTV1. A 2cm margin on the FLAIR was used to create the CTV2. Dose-escalation was confined to the area of gross residual disease with a 3mm margin to create CTV3. A 5mm expansion was used to create all three PTVs. NTCP values were computed using standard models and toxicities calculated for brain and brainstem (necrosis/infarction) and chiasm (blindness) for 4 schedules of dose-escalation - 5x8.5 Gy, 5x9 Gy, 5x9.5 Gy, and 5x10 Gy - compared to 5x7.5 Gy reference plan. Ten patients who underwent STR for newly diagnosed GBM and received standard radiation therapy as per Stupp et al were retrospectively identified. We calculated equivalent BED plans using α/β = 7 (Steel et al) for dose painted HFSRT delivered over 5 fractions as the baseline reference for comparison of toxicities: 5x7.5 Gy to the contrast-enhancing tumor cavity and residual enhancing tumor and 5x6 Gy to FLAIR. A 5mm margin on the cavity and residual enhancing tumor was used to create CTV1. A 2cm margin on the FLAIR was used to create the CTV2. Dose-escalation was confined to the area of gross residual disease with a 3mm margin to create CTV3. A 5mm expansion was used to create all three PTVs. NTCP values were computed using standard models and toxicities calculated for brain and brainstem (necrosis/infarction) and chiasm (blindness) for 4 schedules of dose-escalation - 5x8.5 Gy, 5x9 Gy, 5x9.5 Gy, and 5x10 Gy - compared to 5x7.5 Gy reference plan. ResultsThe Table lists median NTCP risks of increased toxicities (see below). There was no significant risk of increased toxicity to the brainstem or chiasm for any schedule of dose-escalation, compared to baseline (p > 0.48). Although there was a significant risk of increased toxicity to the brain for 5x9.5 Gy (p < 0.02) and 5x10 Gy schedules (p < 0.02), the risk was not significant for 5x8.5 Gy (p > 0.27) and 5x9 Gy schedules (p > 0.17). The Table lists median NTCP risks of increased toxicities (see below). There was no significant risk of increased toxicity to the brainstem or chiasm for any schedule of dose-escalation, compared to baseline (p > 0.48). Although there was a significant risk of increased toxicity to the brain for 5x9.5 Gy (p < 0.02) and 5x10 Gy schedules (p < 0.02), the risk was not significant for 5x8.5 Gy (p > 0.27) and 5x9 Gy schedules (p > 0.17). ConclusionsPoster Viewing Abstract 2142; TableNTCP median risks of increased toxicities for each organ based on dose-escalation schedulesSchedulesBrainBrainstemChiasm5x8.5 Gy0.0330.0060.0345x9 Gy0.0760.0150.0095x9.5 Gy0.1110.0280.0055x10 Gy0.1450.0650.078 Open table in a new tab" @default.
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• W2034106903 title "NTCP Modeling of Dose-escalation Hypofractionated Stereotactic Radiation Therapy (HFSRT) for Patients With Subtotally Resected (STR) Newly Diagnosed Glioblastoma Multiforme (GBM)" @default.
• W2034106903 doi "https://doi.org/10.1016/j.ijrobp.2012.07.709" @default.
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