title: Volumetric modulated arc therapy for hippocampal-sparing radiotherapy in transformed low-grade glioma: A treatment planning case report.
abstract: Timing of radiotherapy for low-grade gliomas is still controversial due to concerns of possible adverse late effects. Prevention of possible late cognitive sequelae by hippocampal avoidance has shown promise in phase II trials. A patient with progressive low-grade glioma with gradual dedifferentiation into anaplastic astrocytoma is presented along with description of radiotherapy planning process attempting to spare the hippocampus. To our knowledge, this is the first described case using volumetric modulated arc technique to spare hippocampus during transformed low-grade glioma radiotherapy. Using modern intensity-modulated radiotherapy systems it is possible to selectively spare hippocampus together with other standard organs at risk. For selected patients, an attempt to spare hippocampus can be considered as long as other dose characteristics are not significantly compromised compared to standard treatment plan created without any effort to avoid hippocampus.
authors.affiliation: Department of radiation oncology, faculty of medicine, Masaryk university, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic; International clinical research center, St. Anne's university hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic. Electronic address: tomas.kazda@mou.cz.
authors.forename: T
authors.initials: T
authors.lastname: Kazda
authors.affiliation: Department of radiation oncology, faculty of medicine, Masaryk university, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic.
authors.forename: P
authors.initials: P
authors.lastname: Pospisil
authors.affiliation: Department of medical physics, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Vrzal
authors.affiliation: Department of medical physics, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic.
authors.forename: O
authors.initials: O
authors.lastname: Sevela
authors.affiliation: Department of medical physics, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Prochazka
authors.affiliation: International clinical research center, St. Anne's university hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic; Department of neurosurgery, faculty of medicine, Masaryk university, St. Anne's university hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic.
authors.forename: R
authors.initials: R
authors.lastname: Jancalek
authors.affiliation: Department of radiation oncology, faculty of medicine, Masaryk university, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic.
authors.forename: P
authors.initials: P
authors.lastname: Slampa
authors.affiliation: Department of radiation oncology, Mayo Clinic, 200, First Street SW, 55905 Rochester, MN, United States.
authors.forename: N N
authors.initials: NN
authors.lastname: Laack
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001254:Astrocytoma / Q000473:pathology; D001925:Brain Damage, Chronic / Q000517:prevention & control; D054337:Cell Dedifferentiation; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects / Q000379:methods*; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D005910:Glioma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D006624:Hippocampus / Q000528:radiation effects*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy*; D059351:Organ Sparing Treatments / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D015173:Supratentorial Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D000077204:Temozolomide; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Astrocytoma; Astrocytome; Cranial irradiation; Hippocampe; Hippocampus; Irradiation de l’encéphale; Neurocognition