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Impact of tumour cell infiltration on treatment outcome in Gamma Knife radiosurgery: a modelling study
Stockholm University, Faculty of Science, Department of Physics.ORCID iD: 0000-0001-6676-508X
Stockholm University, Faculty of Science, Department of Physics.
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2019 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 39, no 4, p. 1675-1687Article in journal (Refereed) Published
Abstract [en]

Background: High-grade gliomas with a widespread infiltration beyond the lesion detectable on diagnostic images are increasingly treated with Gamma Knife™ Radiosurgery (GKRS). The aim of this study was to assess the cell infiltration impact on the GKRS outcome for invasive gliomas. Materials and Methods: Tumor cell distribution was predicted using a novel algorithm whose computations are iterated until they reach an agreement with histopathology results. Treatment plans with different combinations of dose prescription (20 Gy at 50%-20% isodose) and targets [Gross Tumour Volume (GTV), zone 1 with 100%-60% of the GTV cell density and zone 2 with 60%-0% of the GTV cell density] were evaluated using standard conformity indexes (CI) and radiobiological parameters. Results: Considerable differences in terms of tumor control probability were found between plans having similar CI but different targets. Conclusion: To account for tumor cell infiltration outside the target is of key importance in GKRS and a radiobiological evaluation should accompany well-established CI.

Place, publisher, year, edition, pages
2019. Vol. 39, no 4, p. 1675-1687
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Cancer and Oncology Physical Sciences
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URN: urn:nbn:se:su:diva-167968DOI: 10.21873/anticanres.13273ISI: 000463619600005PubMedID: 30952706OAI: oai:DiVA.org:su-167968DiVA, id: diva2:1304278
Available from: 2019-04-11 Created: 2019-04-11 Last updated: 2019-04-29Bibliographically approved

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Lazzeroni, MartaSandström, HelenaToma-Dasu, Iuliana
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