EVALUATION OF TREATMENT VOLUME DETERMINATION FOR ANAPLASTIC OLIGODENDROGLIOMAS BASED ON MULTIMODALITY IMAGING: AN ORIGINAL ARTICLE

Öz

Objective: Utility of radiation therapy (RT) has been well established for management of World Health Organization (WHO) grade 3 anaplastic oligodendroglioma. Nevertheless, optimal target definition for radiotherapeutic management of WHO grade 3 anaplastic oligodendroglioma requires elucidation. Within this context, treatment volume determination for WHO grade anaplastic oligodendroglioma based on multimodality imaging is assessed in this original research article. Materials and methods: Treatment volume determination for RT by incorporation of MRI or by CT-simulation images only was comparatively assessed for patients receiving RT for WHO grade 3 anaplastic oligodendroglioma in this original research article. Results: VersaHD (Elekta, UK) Linear Accelerator (LINAC) was used for treatment with 6 MV photons. IGRT techniques were utilized for treatment verification. Ground truth target volume was used as the reference for actual treatment and for comparison purposes, and it was determined after meticulous evaluation on an individual basis. Primary outcome measure of the study was comparative assessment of treatment volume determination by either CT-only imaging and by CT-MR fusion based imaging. This study revealed that the ground truth target volume was identical with treatment volume definition by CT-MR fusion based imaging. Conclusion: This study reveals improved treatment volume determination for WHO grade 3 anaplastic oligodendrogliomas by incorporation of MRI in the treatment planning procedure. Clearly, further studies are warranted to shed light on this issue.

Anahtar Kelimeler

• WHO grade 3 anaplastic oligodendroglioma
• radiation therapy (RT)
• magnetic resonance imaging (MRI)

ANAPLASTİK OLİGODENDROGLİOMADA GÖRÜNTÜLEME YÖNTEMLERİNİN RADYOTERAPİ TEDAVİ VOLÜMÜNÜ BELİRLEMEDEKİ ETKİSİ

Öz

Giriş ve Amaç: Dünya Sağlık Örgütü (WHO) derece 3 anaplastik oligodendroglioma manajmanında radyasyon tedavisinin (RT) rolü bilinmektedir. Bununla birlikte, WHO derece 3 anaplastik oligodendrogliomanın radyoterapötik manajmanı için optimal hedef tanımının açıklığa kavuşturulması gerekmektedir. Bu bağlamda, bu orijinal araştırma makalesinde, WHO derece 3 anaplastik oligodendroglioma için multimodalite görüntülemeye dayalı tedavi hacminin belirlenmesi değerlendirilmektedir. Gereç ve Yöntemler: Bu orijinal araştırma makalesinde, WHO derece 3 anaplastik oligodendroglioma için RT alan hastalarda MRI dahil edilerek veya yalnızca CT simülasyon görüntüleri ile RT tedavi hacminin belirlenmesi karşılaştırmalı olarak değerlendirildi. Bulgular: 6 MV fotonlarla tedavi için VersaHD (Elekta, UK) Lineer Hızlandırıcı (LINAC) kullanıldı. Tedavi doğrulaması için IGRT teknikleri kullanıldı. Gerçek tedavi ve karşılaştırma amaçlı referans olarak temel gerçek hedef hacmi kullanılmış ve bireysel bazda titiz bir değerlendirmeden sonra belirlenmiştir. Çalışmanın birincil sonuç ölçütü, yalnızca BT görüntüleme ve BT-MR füzyon tabanlı görüntüleme yoluyla tedavi hacmi belirlemenin karşılaştırmalı değerlendirmesiydi. Bu çalışma, temel gerçek hedef hacminin, CT-MR füzyon tabanlı görüntüleme ile tedavi hacmi tanımıyla aynı olduğunu ortaya koydu. Sonuç: Bu çalışma, MRG'nin tedavi planlama prosedürüne dahil edilmesiyle WHO derece 3 anaplastik oligodendrogliomlar için tedavi hacmi belirlemesinin iyileştiğini ortaya koymaktadır. Açıkçası, bu konuyu aydınlatmak için daha fazla çalışmaya ihtiyaç vardır. Anahtar kelimeler: WHO grade 3 anaplastik oligodendroglioma, radyoterapi, manyetik rezonans görüntüleme

Anahtar Kelimeler

• WHO grade 3 anaplastik oligodendroglioma
• radyoterapi
• manyetik rezonans görüntüleme

Kaynakça

1. Polivka, J. Jr, Polivka, J, Rohan, V, Topolcan, O, New treatment paradigm for patients with anaplastic oligodendroglial tumors, Anticancer Research, 2014, 34, 1587-1594.
2. Ostrom, Q.T, Cioffi, G, Gittleman, H, Patil, N, Waite, K, et al., CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012-2016, Neuro-Oncology, 2019, 21, v1-v100.
3. Louis, D.N, Ohgaki, H, Wiestler, O.D, Cavenee, W.K, Burger P.C, et al., The 2007 WHO classification of tumours of the central nervous system, Acta Neuropathologica, 2007, 114, 97-109.
4. Louis, D.N, Perry, A, Reifenberger, G, von Deimling, A, Figarella-Branger, D, et al., 2016, The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary, Acta Neuropathologica, 2016, 131, 803-820.
5. Khalid, L, Carone, M, Dumrongpisutikul, N, Intrapiromkul, J, Bonekamp, D, et al., Imaging characteristics of oligodendrogliomas that predict grade, American Journal of Neuroradiology, 2012, 33, 852-857.
6. Koeller, K.K, Rushing, E.J, From the archives of the AFIP: Oligodendroglioma and its variants: radiologic-pathologic correlation, Radiographics, 2005, 25, 1669-1688.
7. Smits, M, Imaging of oligodendroglioma, British Journal of Radiology, 2016, 89, 20150857.
8. van den Bent, M.J, Chang, S.M, Grade II and III Oligodendroglioma and Astrocytoma, Neurologic Clinics, 2018, 36, 467-484.

9. vanden Bent, M.J, Diagnosis and management of oligodendroglioma, Seminars in Oncology, 2004, 31, 645-652.
10. Bou Zerdan M, Assi, H.I, Oligodendroglioma: A Review of Management and Pathways, Frontiers in Molecular Neuroscience, 2021, 14, 722396.
11. Thon, N, Kreth F.W, Tonn J.C, The role of surgery in grade II/III oligodendroglial tumors, CNS Oncology, 2015, 4, 317-323.
12. Chung, C, Laperriere, N, Radiation therapy and grade II/III oligodendroglial tumors, CNS Oncology, 2015, 4, 325-332.
13. Gonzalez-Aguilar, A, Reyes-Moreno, I, Peiro-Osuna, R.P, Hernandez-Hernandez, A, Gutierrez-Aceves, A, et al., Radiotherapy plus temozolomide or PCV in patients with anaplastic oligodendroglioma, 1p19q codeleted, Revue Neurologique, 2018, 67, 293-297.
14. Cairncross, G, Wang, M, Shaw, E, Jenkins, R, Brachman, D, et al., Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402, Journal of Clinical Oncology, 2013, 31, 337-343.
15. Weller, M, van den Bent, M, Tonn, J.C, Stupp, R, Preusser, M, et al., European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas, Lancet Oncology, 2014, 18: e315-e329.
16. Ryckman, J.M, Surkar, S.M, Haque, W, Butler, E.B, Teh, B.S, et al., Sequencing of Chemotherapy and Radiotherapy for Newly Diagnosed Anaplastic Oligodendroglioma and Oligoastrocytoma, American Journal of Clinical Oncology, 2019, 42, 258-264.
17. Engelhard H.H, Stelea A, Mundt A, Oligodendroglioma and anaplastic oligodendroglioma: clinical features, treatment, and prognosis, Surgical Neurology, 2003, 60, 443-456.
18. van den Bent, M.J, Brandes, A.A, Taphoorn, M.J, Kros, J.M, Kouwenhoven, M.C, et al., Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951, Journal of Clinical Oncology, 2013, 31, 344-350.
19. Khan, K.A, Abbasi, A.N, Ali, N, Treatment updates regarding anaplastic oligodendroglioma and anaplastic oligoastrocytoma, Journal of College Physicians and Surgeons Pakistan, 2014, 24, 935-939.
20. Shin, D.W, Lee, S, Song, S.W, Cho, Y.H, Hong, S.H, et al., Survival outcome and prognostic factors in anaplastic oligodendroglioma: a single-institution study of 95 cases, Scientific Reports, 2020, 10: 20162.
21. Mukherjee, D, Sarmiento, J.M, Nosova, K, Boakye, M, Lad S.P, et al., Effectiveness of radiotherapy for elderly patients with anaplastic gliomas, Journal of Clinical Neuroscience, 2014, 21, 773-778.
22. Turna, G, Kılıc, N, Kurt, G, Dogulu, F, Cevıker, N, An Investigation into KLK5, KLK6 and KLK7 Expressions in Intracranial Tumors, Celal Bayar üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2020; 7(3): 272-277.
23. Kaymak Çerkeşli, Z.A, Özkan, E.E, Evre IB-III Serviks Kanserinde Definitif ve Adjuvan Radyoterapi Sonuçlarının Karşılaştırmalı Değerlendirilmesi, Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2020, 7(2), 117-122.