scholarly journals Patient-Specific Planning for Thermal Magnetic Resonance of Glioblastoma Multiforme

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1867
Author(s):  
Eva Oberacker ◽  
Cecilia Diesch ◽  
Jacek Nadobny ◽  
Andre Kuehne ◽  
Peter Wust ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Magnetic Resonance ◽  
Treatment Planning ◽  
Treatment Options ◽  
Optimization Algorithms ◽  
Current Treatment ◽  
Patient Specific ◽  
Hyperthermia Treatment ◽  
Target Volumes ◽  
Minimum Requirements

Thermal intervention is a potent sensitizer of cells to chemo- and radiotherapy in cancer treatment. Glioblastoma multiforme (GBM) is a potential clinical target, given the cancer’s aggressive nature and resistance to current treatment options. This drives research into optimization algorithms for treatment planning as well as radiofrequency (RF) applicator design for treatment delivery. In this work, nine clinically realistic GBM target volumes (TVs) for thermal intervention are compared using three optimization algorithms and up to ten RF applicator designs for thermal magnetic resonance. Hyperthermia treatment planning (HTP) was successfully performed for all cases, including very small, large, and even split target volumes. Minimum requirements formulated for the metrics assessing HTP outcome were met and exceeded for all patient specific cases. Results indicate a 16 channel two row arrangement to be most promising. HTP of TVs with a small extent in the cranial–caudal direction in conjunction with a large radial extent remains challenging despite the advanced optimization algorithms used. In general, deep seated targets are favorable. Overall, our findings indicate that a one-size-fits-all RF applicator might not be the ultimate approach in hyperthermia of brain tumors. It stands to reason that modular and reconfigurable RF applicator configurations might best suit the needs of targeting individual GBM geometry.

Chronic Myeloid Leukemia

Hematology ◽  
2003 ◽  
Vol 2003 (1) ◽  
pp. 132-152 ◽  
Author(s):  
Junia V. Melo ◽  
Timothy P. Hughes ◽  
Jane F. Apperley
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Molecular Mechanisms ◽  
Treatment Options ◽  
Philadelphia Chromosome ◽  
Current Treatment ◽  
Patient Specific ◽  
Imatinib Treatment ◽  
Molecular Monitoring ◽  
Cytogenetic Analyses

Abstract Chronic myeloid leukemia (CML) was the first human malignancy to be associated with a specific genetic lesion, the Philadelphia chromosome, harboring the BCR-ABL oncogene. Since then, it has become a paradigm for the discovery of molecular mechanisms and targeted therapeutic approaches in the field of hematologic neoplasias. The past 5 years or so have been particularly fruitful in the dissection of the signal transduction pathways abnormally activated in CML and in the translation of this knowledge to clinical practice. In this report, we discuss the biological basis for such translation and highlight the current and potential tools for the effective treatment of CML patients. The first part presents a review of the basic concepts on the biology of CML and their application to the design of targeted therapy. The mechanisms of action of the molecular-specific drugs currently used in clinical trials are discussed, with emphasis on the description of the most promising new compounds that are enhancing the potential for effective alternative or combination chemotherapy in CML. In the following section, we explain how molecular monitoring of response to imatinib mesylate in patients with CML can be used as a guide to clinical management. In particular, we discuss the relative value of regular quantitative RT/PCR and cytogenetic analyses, how responding patients should be monitored and managed, and how to investigate patients who are refractory or become resistant to imatinib treatment. In the last part of this report, a discussion on the possibility of managing CML with patient-specific strategies is presented. We review the current treatment options, highlight the factors impacting on decision making, discuss the range of possibilities for future therapeutic strategies and propose a systematic approach for individualizing treatment for patients in different disease categories.

Chemotherapy use in the treatment of glioblastoma multiforme: Comparing patient characteristics using the National Cancer Data Base (NCDB).

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 305-305
Author(s):  
Christopher J. Inserra ◽  
Nabin Khanal ◽  
Peter T. Silberstein
Keyword(s):  
Glioblastoma Multiforme ◽  
Treatment Options ◽  
Survival Rates ◽  
Patient Characteristics ◽  
The United States ◽  
Current Treatment ◽  
National Cancer Data Base ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Cancer Data

305 Background: Glioblastoma Multiforme (GBM) is the most common and most deadly type of human glioma. Nearly half of all gliomas are diagnosed as GBM at which point the median survival of patients is approximately one year and the two-year survival rates are approximately 10%. Current treatment options for GBM include surgical resection, external beam radiation, and oral temozolomide chemotherapy. However, the patterns of chemotherapy use in GBM as well as the patient characteristics that determine its use have yet to be investigated. Methods: This is a retrospective study of glioblastoma patients (n = 96,966, making this the largest trial ever on glioblastoma) diagnosed between 2000 and 2011 in the NCDB. The NCDB contains nearly 70% of new cancer cases diagnosed in the United States and consists of data from over 1,500 cancer programs across the country. A chi-squared test was used to determine any differences in the characteristics of patients who did or did not receive chemotherapy. Results: Patients who were younger than 70 years of age, male, white, had private/managed insurance, no comorbidities, household income greater than $49,000, were receiving radiation therapy, and diagnosed between 2004 and 2011 were significantly more likely to have received chemotherapy to treat glioblastoma (see Table). Conclusions: Understanding any potential barriers in the use of chemotherapy to treat glioblastoma can help improve its utilization among people of diverse socioeconomic backgrounds. [Table: see text]

scholarly journals Radiofrequency applicator concepts for simultaneous MR imaging and hyperthermia treatment of glioblastoma multiforme

2017 ◽  
Vol 3 (2) ◽  
pp. 473-477 ◽  
Author(s):  
Eva Oberacker ◽  
Andre Kuehne ◽  
Jacek Nadobny ◽  
Sebastian Zschaeck ◽  
Mirko Weihrauch ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Target Volume ◽  
Rf Heating ◽  
Rf Power ◽  
Therapeutic Approaches ◽  
Hyperthermia Treatment ◽  
Large Tumor ◽  
Target Volumes ◽  
Ultrahigh Fields

AbstractGlioblastoma multiforme is the most frequent and most aggressive malignant brain tumor with de facto no long term curation by the use of current multimodal therapeutic approaches. The efficacy of brachytherapy and enhancing interstitial hyperthermia has been demonstrated. RF heating at ultrahigh fields (B0=7.0T, f=298MHz) has the potential of delivering sufficiently large thermal dosage for hyperthermia of relatively large tumor areas. This work focuses on electromagnetic field (EMF) simulations and provides realistic applicator designs tailored for simultaneous RF heating and MRI. Our simulations took advantage of target volumes derived from patient data, and our preliminary results suggest that RF power can be focused to both a small tumor area and a large clinical target volume.

scholarly journals Synergistic Action of Gefitinib and GSK41364A Simultaneously Loaded in Ratiometrically-Engineered Polymeric Nanoparticles for Glioblastoma Multiforme

2019 ◽  
Vol 8 (3) ◽  
pp. 367 ◽  
Author(s):  
Praveena Velpurisiva ◽  
Prakash Rai
Keyword(s):  
Glioblastoma Multiforme ◽  
Polymeric Nanoparticles ◽  
Synergistic Effects ◽  
Treatment Options ◽  
Survival Rates ◽  
Current Treatment ◽  
New Combination ◽  
Single Drug ◽  
Drug Concentrations ◽  
Multiple Drugs

Glioblastoma Multiforme is a deadly cancer of glial cells with very low survival rates. Current treatment options are invasive and have serious side effects. Single drug treatments make the tumor refractory after a certain period. Combination therapies have shown improvements in treatment responses against aggressive forms of cancer and are becoming a mainstay in the management of cancer. The purpose of this study is to design a combinatorial treatment regimen by engineering desired ratios of two different small molecule drugs (gefitinib and GSK461364A) in a single carrier that can reduce off-target effects and increase their bioavailability. Synergistic effects were observed with our formulation when optimal ratios of gefitinib and GSK461364A were loaded in poly (lactic-co-glycolic) acid and polyethylene glycol (PLGA-PEG) nanoparticles and tested for efficacy in U87-malignant glioma (U87-MG) cells. Combination nanoparticles proved to be more effective compared to single drug encapsulated nanoparticles, free drug combinations, and the mixture of two single loaded nanoparticles, with statistically significant values at certain ratios and drug concentrations. We also observed drastically reduced clonogenic potential of the cells that were treated with free drugs and nanoparticle combinations in a colony forming assay. From our findings, we conclude that the combination of GSK461364A and higher concentrations of gefitinib when encapsulated in nanoparticles yield synergistic killing of glioma cells. This study could form the basis for designing new combination treatments using nanoparticles to deliver multiple drugs to cancer cells for synergistic effects.

scholarly journals Impact of Number of Segmented Tissues on SAR Prediction Accuracy in Deep Pelvic Hyperthermia Treatment Planning

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2646
Author(s):  
Iva VilasBoas-Ribeiro ◽  
Gerard C. van Rhoon ◽  
Tomas Drizdal ◽  
Martine Franckena ◽  
Margarethus M. Paulides
Keyword(s):  
Treatment Planning ◽  
High Water ◽  
Specific Model ◽  
Treatment Quality ◽  
Patient Specific ◽  
High Water Content ◽  
Treatment Optimization ◽  
Hyperthermia Treatment ◽  
Pre Treatment ◽  
The Impact

In hyperthermia, the general opinion is that pre-treatment optimization of treatment settings requires a patient-specific model. For deep pelvic hyperthermia treatment planning (HTP), tissue models comprising four tissue categories are currently discriminated. For head and neck HTP, we found that more tissues are required for increasing accuracy. In this work, we evaluated the impact of the number of segmented tissues on the predicted specific absorption rate (SAR) for the pelvic region. Highly detailed anatomical models of five healthy volunteers were selected from a virtual database. For each model, seven lists with varying levels of segmentation detail were defined and used as an input for a modeling study. SAR changes were quantified using the change in target-to-hotspot-quotient and maximum SAR relative differences, with respect to the most detailed patient model. The main finding of this study was that the inclusion of high water content tissues in the segmentation may result in a clinically relevant impact on the SAR distribution and on the predicted hyperthermia treatment quality when considering our pre-established thresholds. In general, our results underline the current clinical segmentation protocol and help to prioritize any improvements.

scholarly journals Modelling Curved Contact Flexible Microstrip Applicators for Patient-Specific Superficial Hyperthermia Treatment Planning

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 656 ◽  
Author(s):  
H. Petra Kok ◽  
Jort Groen ◽  
Akke Bakker ◽  
Johannes Crezee
Keyword(s):  
Ct Scan ◽  
Treatment Planning ◽  
Specific Treatment ◽  
Treatment Quality ◽  
Patient Specific ◽  
Maximum Deviation ◽  
Hyperthermia Treatment ◽  
Clinical Patient ◽  
Superficial Hyperthermia ◽  
Average Maximum

This paper describes a method to reconstruct bendable superficial hyperthermia applicators for routine clinical patient-specific treatment planning. The reconstruction uses a CT scan with a flexible silicone dummy applicator positioned on the patient. The curvature was approximated by two second-degree polynomial functions. A realistic treatment series was mimicked using a standard Alderson radiation therapy phantom and a treatment planning model was reconstructed from a CT scan. The variation among treatment curvatures was compared to the modelled curvature. The mathematical approximation of the applicator curvature was validated for this phantom experiment, as well as for clinical treatments. The average maximum variation among the successive mimicked sessions was 3.67 ± 0.69 mm (range 2.98–4.60 mm). The maximum deviation between the treatment curvature and the modelled curvature was 4.35 mm. Comparing the treatment and approximated curvature yielded a maximum deviation between 2.98 mm and 4.12 mm. For clinical treatments the maximum deviation of the treatment and approximated curvature varied between 0.48 mm and 1.98 mm. These results allow adequate reconstruction of bendable hyperthermia applicators for treatment planning, which can further improve treatment quality, for example by optimizing the water bolus temperature for patient-specific tumor depths. Predictive parameters for hyperthermia treatment outcome can easily be evaluated and compared for various input parameters.

scholarly journals An Unusual Presentation of Spinal Giant Cell Glioblastoma in a 21-Year-Old Female

2019 ◽  
Vol 7 ◽  
pp. 232470961986825
Author(s):  
Benjamin J. Delgado ◽  
Leila Moosavi ◽  
Ericka Rangel ◽  
William Stull ◽  
Rahul Dev Polineni ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Glioblastoma Multiforme ◽  
Giant Cell ◽  
Treatment Options ◽  
Spinal Cord Tumor ◽  
Current Treatment ◽  
World Health ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Giant Cell Glioblastoma

Primary spinal cord giant cell glioblastoma multiforme of the thoracic spinal cord is a rarely-diagnosed primary spinal cord tumor in comparison to neoplasms in intracranial locations. In this article, we highlight a young adult who was diagnosed with intramedullary giant cell glioblastoma, IDH wild-type, World Health Organization grade IV/IV of the thoracic spinal cord. This case report describes the treatment approach with a postsurgical combination of radiation therapy and temozolomide, which resulted in the patient to return to her baseline of health only to later develop neurological symptoms significant for a recurrence of malignancy. In a review of the literature of described cases of primary spinal cord glioblastoma multiforme, prognosis continues to be unfavorable as current treatment options of the aggressive malignancy remain absent of a cure.

scholarly journals Advanced patient-specific hyperthermia treatment planning

2020 ◽  
Vol 37 (1) ◽  
pp. 992-1007
Author(s):  
Soraya Gavazzi ◽  
Astrid L. H. M. W. van Lier ◽  
Cornel Zachiu ◽  
Eric Jansen ◽  
Jan J. W Lagendijk ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Patient Specific ◽  
Hyperthermia Treatment

scholarly journals P13.07 Multi-omics as a tool for elucidating temozolomide resistance in glioblastoma multiforme

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii63-iii63
Author(s):  
F Fabro ◽  
E Tóth ◽  
L J M Dekker ◽  
T M Luider ◽  
T M Pierson ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Treatment Options ◽  
Tumor Resection ◽  
Treatment Strategies ◽  
Recurrent Glioblastoma ◽  
Biological Information ◽  
Patient Specific ◽  
Complex Nature ◽  
Current Standard ◽  
Medical Software

Abstract BACKGROUND Glioblastoma multiforme is the most common and aggressive brain tumor in adults, with an average overall survival of 14 months. Current standard of care consists of tumor resection followed by radiotherapy with concomitant temozolomide and adjuvant temozolomide. However, glioblastoma recurs in all patients. The causes reside in the enhanced invasiveness and resistance to treatment, giving a clear indication that recurrent and resistant glioblastoma biology must be understood better in order to achieve future treatment strategies to benefit the patients. The complex nature of recurrent glioblastoma makes its understanding still a challenging achievement in the field. Nowadays multi-omics approaching is developing further and further and it may be used to unravel, by combining different layers of biological information, a comprehensive view of the changes occurring during the treatment. MATERIAL AND METHODS A discovery set of 13 primary patient-derived glioblastoma stem-like cultures were analysed, comprising selected resistant, induced resistant and with pre-existing resistance conditions. A characterization of transcriptome, proteome and phosphoproteome was performed using RNAseq and liquid chromatography mass spectrometry. Additional 10 paired primary and recurrent tumor tissues were utilized as a validation set. The data obtained was visualised, explored and integrated through TIBCO Spotfire, Ingenuity Pathway Analysis, STRING and COREMINE medical software. RESULTS Genetic regulatory processes such as DNA repair mechanism, mRNA splicing and chromatin assembly were shown to be common over-represented trends in resistant and recurrent glioblastomas as a result of increased genomic instability and stress deriving from acute an repeated temozolomide exposure. Due to the immense heterogeneity of glioblastomas, other proteins and genes here identified as differentially expressed need a further investigation as they also may play an important role in relevant biological processes in a patient-specific way. CONCLUSION This study provides further understanding of glioblastoma biology revealing an association with processes of recurrence and temozolomide resistance, moreover offering potential therapeutic targets for better treatment options for glioblastoma patients.

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