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Implementation of Minimally Invasive Brain Tumor Resection in Rodents for High Viability Tissue Collection
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Anatomical changes in resection cavity during brain radiotherapy.

Yves C P Willems1, Femke Vaassen2, Catharina M L Zegers1

  • 1Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands.

Journal of Neuro-Oncology
|December 14, 2023
PubMed
Summary

Resection cavities (RCs) in brain tumors change significantly during radiotherapy. A 4mm expansion is often needed to cover the changing RC volume, highlighting the need for adaptive planning.

Keywords:
Anatomical changesNeuro-oncologyRadiotherapyResection cavity

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Area of Science:

  • Radiation oncology
  • Neurosurgery
  • Medical imaging

Background:

  • Brain tumors require maximal safe resection followed by radiotherapy and chemotherapy.
  • Anatomical changes in the resection cavity (RC) during radiotherapy can compromise target volume coverage.
  • Quantifying RC changes and identifying risk factors is crucial for effective treatment.

Purpose of the Study:

  • To quantify anatomical changes in the resection cavity (RC) during radiotherapy.
  • To identify risk factors associated with RC volume changes.
  • To assess the impact of these changes on target volume coverage in brain tumor patients.

Main Methods:

  • Retrospective analysis of 16 patients undergoing pencil beam scanning proton therapy.
  • Delineation of the RC on pre-treatment imaging and weekly CT scans.
  • Quantification of RC volume changes and evaluation of risk factors using Spearman's rank correlation coefficient.

Main Results:

  • Average relative RC volume variation was 26.1% during treatment.
  • A 4mm expansion of pre-treatment RC volumes was needed to cover >95% of the RC in >90% of patients.
  • Significant correlation found between pre-treatment RC volume and volume changes during treatment (Spearman's ρ = -0.644, p = 0.007).

Conclusions:

  • Resection cavities are dynamic structures after surgery.
  • An additional margin for RCs in brain cancer patients may be necessary to ensure adequate target coverage.
  • Further research into local recurrence patterns is recommended.