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
Hauptverfasser: Rose, J.Holt, Norman, Amos, Ingram, Marylou, Aoki, Chuck, Solberg, Tim, Mesa, Albert
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container_end_page 1132
container_issue 5
container_start_page 1127
container_title International journal of radiation oncology, biology, physics
container_volume 45
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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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. 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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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