First radiotherapy of human metastatic brain tumors delivered by a computerized tomography scanner (CTRx)
Purpose: This Phase I study was designed to evaluate the computed tomography (CT) scanner as a device for radiation therapy of human brain tumors (CTRx). This first use in humans of a modified CT for treatment was founded on extensive research experience with canine tumors. An additional objective w...
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Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 1999-12, Vol.45 (5), p.1127-1132 |
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creator | Rose, J.Holt Norman, Amos Ingram, Marylou Aoki, Chuck Solberg, Tim Mesa, Albert |
description | Purpose: This Phase I study was designed to evaluate the computed tomography (CT) scanner as a device for radiation therapy of human brain tumors (CTRx). This first use in humans of a modified CT for treatment was founded on extensive research experience with canine tumors. An additional objective was to increase the therapeutic radiation dose to tumors compared to normal tissue by concentration of infused contrast material in tumors, an effect available at diagnostic x-ray energies but not at megavoltage energies.
Methods and Materials: A small metastatic brain tumor in each of eight patients received 3–5-weekly fractions of 5 Gy equivalent per fraction from a CT scanner modified to deliver radiation therapy. In each patient, one additional tumor, lying completely outside the volume treated by CTRx, served as a control. The tumor receiving CTRx was treated after infusion of iodinated x-ray contrast media (CM) for dose enhancement. Many of these patients also received conventional 40 Gy whole brain radiation, before, during, or after CTRx treatment.
Results: None of the patients showed adverse reactions to the CM or necrosis of the normal brain from the CTRx boost radiation. Monte Carlo calculations of the radiation dose distributions in a model tumor showed that the CTRx irradiation of tumors carrying 10 mg or more of iodine per gram of tumor was as good or better than the dose distribution from conventional 10-MV X-rays. The treated tumor in two of the patients vanished after four treatments, whereas a control tumor in one patient remained constant and grew 4-fold in another patient.
Conclusion: The CTRx concept effectively combines a modified CT scanner as a diagnostic device, as a simulator dedicated to radiotherapy, and as a treatment machine. Thus, CTRx could be very useful for radiation oncologists in controlling CM-enhanced and other small brain tumors. |
doi_str_mv | 10.1016/S0360-3016(99)00347-8 |
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Methods and Materials: A small metastatic brain tumor in each of eight patients received 3–5-weekly fractions of 5 Gy equivalent per fraction from a CT scanner modified to deliver radiation therapy. In each patient, one additional tumor, lying completely outside the volume treated by CTRx, served as a control. The tumor receiving CTRx was treated after infusion of iodinated x-ray contrast media (CM) for dose enhancement. Many of these patients also received conventional 40 Gy whole brain radiation, before, during, or after CTRx treatment.
Results: None of the patients showed adverse reactions to the CM or necrosis of the normal brain from the CTRx boost radiation. Monte Carlo calculations of the radiation dose distributions in a model tumor showed that the CTRx irradiation of tumors carrying 10 mg or more of iodine per gram of tumor was as good or better than the dose distribution from conventional 10-MV X-rays. The treated tumor in two of the patients vanished after four treatments, whereas a control tumor in one patient remained constant and grew 4-fold in another patient.
Conclusion: The CTRx concept effectively combines a modified CT scanner as a diagnostic device, as a simulator dedicated to radiotherapy, and as a treatment machine. Thus, CTRx could be very useful for radiation oncologists in controlling CM-enhanced and other small brain tumors.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/S0360-3016(99)00347-8</identifier><identifier>PMID: 10613304</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Brain Neoplasms - diagnostic imaging ; Brain Neoplasms - radiotherapy ; Brain Neoplasms - secondary ; Brain radiotherapy ; Cause of Death ; Contrast Media ; Dose Fractionation, Radiation ; Humans ; Medical sciences ; Monte Carlo Method ; Radiation dose enhancement ; Radiation therapy and radiosensitizing agent ; Radiosurgery ; Stereotactic techniques ; Tomography Scanners, X-Ray Computed ; Tomography, X-Ray Computed ; Treatment with physical agents ; Treatment. General aspects ; Tumors</subject><ispartof>International journal of radiation oncology, biology, physics, 1999-12, Vol.45 (5), p.1127-1132</ispartof><rights>1999 Elsevier Science Inc.</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-d3496a90a469ba0389f6196557c4831024bae6e13589967032c1bf48aad84ed13</citedby><cites>FETCH-LOGICAL-c456t-d3496a90a469ba0389f6196557c4831024bae6e13589967032c1bf48aad84ed13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301699003478$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1229164$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10613304$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rose, J.Holt</creatorcontrib><creatorcontrib>Norman, Amos</creatorcontrib><creatorcontrib>Ingram, Marylou</creatorcontrib><creatorcontrib>Aoki, Chuck</creatorcontrib><creatorcontrib>Solberg, Tim</creatorcontrib><creatorcontrib>Mesa, Albert</creatorcontrib><title>First radiotherapy of human metastatic brain tumors delivered by a computerized tomography scanner (CTRx)</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose: This Phase I study was designed to evaluate the computed tomography (CT) scanner as a device for radiation therapy of human brain tumors (CTRx). This first use in humans of a modified CT for treatment was founded on extensive research experience with canine tumors. An additional objective was to increase the therapeutic radiation dose to tumors compared to normal tissue by concentration of infused contrast material in tumors, an effect available at diagnostic x-ray energies but not at megavoltage energies.
Methods and Materials: A small metastatic brain tumor in each of eight patients received 3–5-weekly fractions of 5 Gy equivalent per fraction from a CT scanner modified to deliver radiation therapy. In each patient, one additional tumor, lying completely outside the volume treated by CTRx, served as a control. The tumor receiving CTRx was treated after infusion of iodinated x-ray contrast media (CM) for dose enhancement. Many of these patients also received conventional 40 Gy whole brain radiation, before, during, or after CTRx treatment.
Results: None of the patients showed adverse reactions to the CM or necrosis of the normal brain from the CTRx boost radiation. Monte Carlo calculations of the radiation dose distributions in a model tumor showed that the CTRx irradiation of tumors carrying 10 mg or more of iodine per gram of tumor was as good or better than the dose distribution from conventional 10-MV X-rays. The treated tumor in two of the patients vanished after four treatments, whereas a control tumor in one patient remained constant and grew 4-fold in another patient.
Conclusion: The CTRx concept effectively combines a modified CT scanner as a diagnostic device, as a simulator dedicated to radiotherapy, and as a treatment machine. Thus, CTRx could be very useful for radiation oncologists in controlling CM-enhanced and other small brain tumors.</description><subject>Biological and medical sciences</subject><subject>Brain Neoplasms - diagnostic imaging</subject><subject>Brain Neoplasms - radiotherapy</subject><subject>Brain Neoplasms - secondary</subject><subject>Brain radiotherapy</subject><subject>Cause of Death</subject><subject>Contrast Media</subject><subject>Dose Fractionation, Radiation</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Monte Carlo Method</subject><subject>Radiation dose enhancement</subject><subject>Radiation therapy and radiosensitizing agent</subject><subject>Radiosurgery</subject><subject>Stereotactic techniques</subject><subject>Tomography Scanners, X-Ray Computed</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment with physical agents</subject><subject>Treatment. General aspects</subject><subject>Tumors</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMGKFDEQhoMo7rj6CEoOIruH1mSSTicnkcFVYUHQFbyF6qTaiXR3xiS9OD69mZ1BvXmqovj-quIj5ClnLznj6tVnJhRrRG0vjLlkTMiu0ffIiuvONKJtv94nqz_IGXmU83fGGOedfEjOOFNcCCZXJFyFlAtN4EMsW0yw29M40O0ywUwnLJALlOBonyDMtCxTTJl6HMMtJvS031OgLk67pWAKv-qkxCl-q2u2e5odzDMmerG5-fTz8jF5MMCY8cmpnpMvV29vNu-b64_vPmzeXDdOtqo0XkijwDCQyvTAhDaD4ka1beekFpytZQ-okItWG6M6JtaO94PUAF5L9FyckxfHvbsUfyyYi51CdjiOMGNcslVGdLraqmB7BF2KOScc7C6FCdLecmYPju2dY3sQaI2xd46trrlnpwNLP6H_J3WUWoHnJwCqgnFIMLuQ_3LrteHqgL0-Ylht3AZMNruAs0MfErpifQz_-eQ3jRWYoA</recordid><startdate>19991201</startdate><enddate>19991201</enddate><creator>Rose, J.Holt</creator><creator>Norman, Amos</creator><creator>Ingram, Marylou</creator><creator>Aoki, Chuck</creator><creator>Solberg, Tim</creator><creator>Mesa, Albert</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19991201</creationdate><title>First radiotherapy of human metastatic brain tumors delivered by a computerized tomography scanner (CTRx)</title><author>Rose, J.Holt ; Norman, Amos ; Ingram, Marylou ; Aoki, Chuck ; Solberg, Tim ; Mesa, Albert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-d3496a90a469ba0389f6196557c4831024bae6e13589967032c1bf48aad84ed13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Biological and medical sciences</topic><topic>Brain Neoplasms - diagnostic imaging</topic><topic>Brain Neoplasms - radiotherapy</topic><topic>Brain Neoplasms - secondary</topic><topic>Brain radiotherapy</topic><topic>Cause of Death</topic><topic>Contrast Media</topic><topic>Dose Fractionation, Radiation</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Monte Carlo Method</topic><topic>Radiation dose enhancement</topic><topic>Radiation therapy and radiosensitizing agent</topic><topic>Radiosurgery</topic><topic>Stereotactic techniques</topic><topic>Tomography Scanners, X-Ray Computed</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment with physical agents</topic><topic>Treatment. General aspects</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rose, J.Holt</creatorcontrib><creatorcontrib>Norman, Amos</creatorcontrib><creatorcontrib>Ingram, Marylou</creatorcontrib><creatorcontrib>Aoki, Chuck</creatorcontrib><creatorcontrib>Solberg, Tim</creatorcontrib><creatorcontrib>Mesa, Albert</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rose, J.Holt</au><au>Norman, Amos</au><au>Ingram, Marylou</au><au>Aoki, Chuck</au><au>Solberg, Tim</au><au>Mesa, Albert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>First radiotherapy of human metastatic brain tumors delivered by a computerized tomography scanner (CTRx)</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>1999-12-01</date><risdate>1999</risdate><volume>45</volume><issue>5</issue><spage>1127</spage><epage>1132</epage><pages>1127-1132</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose: This Phase I study was designed to evaluate the computed tomography (CT) scanner as a device for radiation therapy of human brain tumors (CTRx). This first use in humans of a modified CT for treatment was founded on extensive research experience with canine tumors. An additional objective was to increase the therapeutic radiation dose to tumors compared to normal tissue by concentration of infused contrast material in tumors, an effect available at diagnostic x-ray energies but not at megavoltage energies.
Methods and Materials: A small metastatic brain tumor in each of eight patients received 3–5-weekly fractions of 5 Gy equivalent per fraction from a CT scanner modified to deliver radiation therapy. In each patient, one additional tumor, lying completely outside the volume treated by CTRx, served as a control. The tumor receiving CTRx was treated after infusion of iodinated x-ray contrast media (CM) for dose enhancement. Many of these patients also received conventional 40 Gy whole brain radiation, before, during, or after CTRx treatment.
Results: None of the patients showed adverse reactions to the CM or necrosis of the normal brain from the CTRx boost radiation. Monte Carlo calculations of the radiation dose distributions in a model tumor showed that the CTRx irradiation of tumors carrying 10 mg or more of iodine per gram of tumor was as good or better than the dose distribution from conventional 10-MV X-rays. The treated tumor in two of the patients vanished after four treatments, whereas a control tumor in one patient remained constant and grew 4-fold in another patient.
Conclusion: The CTRx concept effectively combines a modified CT scanner as a diagnostic device, as a simulator dedicated to radiotherapy, and as a treatment machine. Thus, CTRx could be very useful for radiation oncologists in controlling CM-enhanced and other small brain tumors.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10613304</pmid><doi>10.1016/S0360-3016(99)00347-8</doi><tpages>6</tpages></addata></record> |
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subjects | Biological and medical sciences Brain Neoplasms - diagnostic imaging Brain Neoplasms - radiotherapy Brain Neoplasms - secondary Brain radiotherapy Cause of Death Contrast Media Dose Fractionation, Radiation Humans Medical sciences Monte Carlo Method Radiation dose enhancement Radiation therapy and radiosensitizing agent Radiosurgery Stereotactic techniques Tomography Scanners, X-Ray Computed Tomography, X-Ray Computed Treatment with physical agents Treatment. General aspects Tumors |
title | First radiotherapy of human metastatic brain tumors delivered by a computerized tomography scanner (CTRx) |
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