PT  - JOURNAL ARTICLE
AU  - MARTA LAZZERONI
AU  - ZOHREH KHAZRAEI MANESH
AU  - HELENA SANDSTRÖM
AU  - PIERRE BARSOUM
AU  - IULIANA TOMA-DASU
TI  - Impact of Tumour Cell Infiltration on Treatment Outcome in Gamma Knife Radiosurgery: A Modelling Study
AID  - 10.21873/anticanres.13273
DP  - 2019 Apr 01
TA  - Anticancer Research
PG  - 1675--1687
VI  - 39
IP  - 4
4099  - http://ar.iiarjournals.org/content/39/4/1675.short
4100  - http://ar.iiarjournals.org/content/39/4/1675.full
SO  - Anticancer Res2019 Apr 01; 39
AB  - Background: High-grade gliomas with a widespread infiltration beyond the lesion detectable on diagnostic images are increasingly treated with Gamma Knife™ Radiosurgery (GKRS). The aim of this study was to assess the cell infiltration impact on the GKRS outcome for invasive gliomas. Materials and Methods: Tumor cell distribution was predicted using a novel algorithm whose computations are iterated until they reach an agreement with histopathology results. Treatment plans with different combinations of dose prescription (20 Gy at 50%-20% isodose) and targets [Gross Tumour Volume (GTV), zone 1 with 100%-60% of the GTV cell density and zone 2 with 60%-0% of the GTV cell density] were evaluated using standard conformity indexes (CI) and radiobiological parameters. Results: Considerable differences in terms of tumor control probability were found between plans having similar CI but different targets. Conclusion: To account for tumor cell infiltration outside the target is of key importance in GKRS and a radiobiological evaluation should accompany well-established CI.