Evidence map›Paper›PMID 33389825›Full record

Trial reportJournal of applied clinical medical physics2021

Dosimetric impact of the positioning variation of tumor treating field electrodes in the PriCoTTF-phase I/II trial.

Youness Nour, Christoph Pöttgen, Sied Kebir, Lazaros Lazaridis, Lutz Lüdemann, Maja Guberina, Thomas Gauler, Björn Scheffler, Ramazan Jabbarli, Daniela Pierscianek and 8 more

Open access · goldAbstract readClinical Trial, Phase IClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of applied clinical medical physics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 1 country.

Youness NourDepartment of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Christoph PöttgenDepartment of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Sied KebirDivision of Clinical Neurooncology, Department of Neurology and West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Lazaros LazaridisDivision of Clinical Neurooncology, Department of Neurology and West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Lutz LüdemannDepartment of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Maja GuberinaDepartment of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Thomas GaulerDepartment of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Björn SchefflerDKFZ-Division Translational Neurooncology at the West German Cancer Centre (WTZ), German Cancer Consortium (DKTK), Partner Site University Hospital Essen, University of Duisburg, Essen, Germany.
Ramazan JabbarliDepartment of Neurosurgery, University Hospital Essen, University of Duisburg, Essen, Germany.
Daniela PierscianekDepartment of Neurosurgery, University Hospital Essen, University of Duisburg, Essen, Germany.
Ulrich SureGerman Cancer Consortium (DKTK), Partner Site University Hospital Essen, Germany.
Teresa SchmidtDivision of Clinical Neurooncology, Department of Neurology and West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Christoph OsterDivision of Clinical Neurooncology, Department of Neurology and West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Peter HauDepartment of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Germany.
Martin GlasDivision of Clinical Neurooncology, Department of Neurology and West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Wolfgang LübckeDepartment of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Martin StuschkeDepartment of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
Nika GuberinaDepartment of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg, Essen, Germany.
West German Heart and Vascular Center Essen · DEEssen University Hospital · DEGerman Cancer Research Center · DEUniversity of Duisburg-Essen · DEUniversity Hospital Regensburg · DE

Funding

University of Duisburg-Essen
6 · The paper itself

Abstract

purposeThe aim of the present study based on the PriCoTTF-phase I/II trial is the quantification of skin-normal tissue complication probabilities of patients with newly diagnosed glioblastoma multiforme treated with Tumor Treating Field (TTField) electrodes, concurrent radiotherapy, and temozolomide. Furthermore, the skin-sparing effect by the clinically applied strategy of repetitive transducer array fixation around their center position shall be examined. MATERIAL AND

methodsLow-dose cone-beam computed tomography (CBCT) scans of all fractions of the first seven patients of the PriCoTTF-phase I/II trial, used for image guidance, were applied for the dosimetric analysis, for precise TTField transducer array positioning and contour delineation. Within this trial, array positioning was varied from fixation-to-fixation period with a standard deviation of 1.1 cm in the direction of the largest variation of positioning and 0.7 cm in the perpendicular direction. Physical TTField electrode composition was examined and a respective Hounsfield Unit attributed to the TTField electrodes. Dose distributions in the planning CT with TTField electrodes in place, as derived from prefraction CBCTs, were calculated and accumulated with the algorithm Acuros XB. Dose-volume histograms were obtained for the first and second 2 mm scalp layer with and without migrating electrodes and compared with those with fixed electrodes in an average position. Skin toxicity was quantified according to Lyman's model. Minimum doses in hot-spots of 0.05 cm

resultsNormal tissue complication probabilities (NTCPs) for skin necrosis ranged from 0.005% to 1.474% (median 0.111%) for the different patients without electrodes. NTCP logarithms were significantly dependent on patient (P < 0.0001) and scenario (P < 0.0001) as classification variables. Fixed positioning of TTField arrays increased skin-NTCP by a factor of 5.50 (95%, CI: 3.66-8.27). The variation of array positioning increased skin-NTCP by a factor of only 3.54 (95%, CI: 2.36-5.32) (P < 0.0001, comparison to irradiation without electrodes; P = 0.036, comparison to irradiation with fixed electrodes). NTCP showed a significant rank correlation with D25cm

conclusionSkin-NTCP calculation uncovers significant interpatient heterogeneity and may be used to stratify patients into high- and low-risk groups of skin toxicity. Array position variation may mitigate about one-third of the increase in surface dose and skin-NTCP by the TTField electrodes.

Indexed as

GlioblastomaRadiotherapy Planning, Computer-AssistedElectrodesHumansRadiometryRadiotherapy Dosagedosimetryglioblastomanon-coplanar IMRTtumor treating fields

Identifiers

PMID33389825
PMCPMC7856507
OpenAlexW3120319970

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.