Consensus Radiation Treatment Planning Guidelines Using (68)Ga-DOTATATE PET/CT For Resected Meningiomas.

IF 6.4 1区 医学 Q1 ONCOLOGY
Haley K Perlow, David R Raleigh, Tony J C Wang, Erqi L Pollom, Michael T Milano, William G Breen, Jay Detsky, Eric L Chang, Martin C Tom, Kevin R Shiue, Eric J Lehrer, Hina Saeed, Luke R G Pike, Simon S Lo, Mark V Mishra, Jonathan P S Knisely, Samuel T Chao, Arjun Sahgal, Joshua D Palmer
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引用次数: 0

Abstract

Purpose: Meningiomas are the most common primary intracranial tumor. Somatostatin receptor 2 is almost universally expressed in meningioma tissue. For patients who require adjuvant radiation, somatostatin receptor based (68)Ga-DOTATATE positron emission tomography (PET) imaging can detect additional or residual disease not discernible on magnetic resonance imaging. PET guided radiation treatments may improve local control, minimize toxicity by allowing for more precise radiation therapy plans, and allow for more precise dose-escalation to maximize local control. The aim of this study was to develop consensus PET guided treatment planning guidelines for common meningioma presentations.

Methods and materials: Five postoperative clinically relevant meningioma cases were selected from a prospective single-institutional registry of patients. Each patient had a preoperative and postoperative contrast-enhanced T1-weighted volumetric magnetic resonance imaging, and a postoperative (68)Ga-DOTATATE PET/CT, to assist with target delineation. The full treatment scenario including clinical history, histology, surgical history, and imaging were provided for each patient. Nineteen international experts who have published on the treatment and management of meningiomas, and who use (68)Ga-DOTATATE PET/CT in their practice, evaluated each case. Individual prescription recommendations were created, pooled, and discussed to create consensus recommendations.

Results: Consensus recommendations were created for each case. In most cases, PET-based contouring allowed for more precise dose-escalation to 66-70 Gy targeting residual disease. When compared to RTOG 0539 and modern clinical trial contouring guidelines, a smaller clinical target volume expansion from the surgical cavity was recommended using PET guided radiation plans in the absence of radiographic or pathologic evidence of brain or bone invasion.

Conclusions: This report provides consensus target volume delineation guidelines for meningiomas receiving postoperative radiation in common clinical situations. Integration of these guidelines into clinical practice may allow for more precise biomarker guided radiation treatments and standardize radiation therapy on future meningioma clinical trials.

使用Ga-DOTATATE PET/CT治疗切除脑膜瘤的一致放射治疗计划指南。
背景:脑膜瘤是最常见的原发性颅内肿瘤。生长抑素受体2 (SSTR 2)在脑膜瘤组织中几乎普遍表达。对于需要辅助放疗的患者,基于SSTR的(68)Ga-DOTATATE正电子发射断层扫描(PET)成像可以检测磁共振成像(MRI)无法识别的额外或残留疾病。pet引导的放射治疗可以改善局部控制,通过更精确的放射治疗计划将毒性降到最低,并允许更精确的剂量递增以最大限度地提高局部控制。本研究的目的是为常见脑膜瘤的临床表现制定一致的pet指导治疗计划指南。方法:从前瞻性单一机构登记的患者中选择5例术后临床相关的脑膜瘤病例。每位患者术前和术后均行增强t1加权体积MRI检查,术后(68)Ga-DOTATATE PET/CT检查,以协助靶区描绘。提供了每位患者的完整治疗方案,包括临床病史、组织学、手术史和影像学。19位国际专家发表了关于脑膜瘤治疗和管理的文章,并在实践中使用了Ga-DOTATATE PET/CT,对每个病例进行了评估。个人处方建议被创建、汇总和讨论,以形成共识建议。结果:针对每个病例提出了一致的建议。在大多数情况下,pet为基础的轮廓允许更精确的剂量递增到66-70Gy靶向残留疾病。与RTOG 0539和现代临床试验轮廓指南相比,在没有影像学或病理证据表明脑或骨侵犯的情况下,推荐使用pet引导的放射计划,从手术腔中进行较小的CTV扩张。结论:本报告为常见临床情况下脑膜瘤术后放疗提供了一致的靶体积划定指南。将这些指南整合到临床实践中,可以使生物标志物引导的放射治疗更加精确,并使未来脑膜瘤临床试验的放射治疗标准化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
11.00
自引率
7.10%
发文量
2538
审稿时长
6.6 weeks
期刊介绍: International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.
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