![]() ![]() Leveraging the capacity of PBS to define anatomic dose delivery by treatment layer in a time-dependent manner, this study sought to correlate timing of taste/odor changes with layer-defined dose delivered to the OS and Bragg peak location relative to the OS. Purpose: Patients undergoing brain irradiation report unpleasant taste/odor changes. We are currently evaluating this in a larger patient cohort and comparing IMPT with VMAT. Hippocampal sparing IMPT failed in one case with the largest tumor volume (650cc) where 2/3 of the hippocampus overlapped the target volume.Ĭonclusion: IMPT as compared to IMRT and 3DCRT plans showed a trend towards significant and effective hippocampal sparing in adult patients with primary brain tumors. ![]() The largest median hippocampal dose reduction was seen with IMPT, with a mean median hippocampal dose of 4.8Gy (range:0.0Gy–24.9Gy), 14.6Gy (range:1.9Gy–21.7Gy), and 16.2Gy (range:2.3Gy–25.0Gy) for IMPT, IMRT and 3DCRT respectively. Results: Hippocampal sparing was achieved in 19 patients (95%) with IMPT, 16 patients (80%) with IMRT and 13 patients (65%) with 3DCRT. Hippocampal sparing was defined as median dose to contralateral hippocampus ≤25Gy without compromising target coverage and organ at risk dose constraints. Three hippocampal sparing plans were generated for each patient with specific prescriptions (54Gy/30 fractions, 60Gy/30 fractions and 59.4Gy/33 fractions) using IMPT, IMRT and 3DCRT. A pre-operative diagnostic MRI scan was fused with the planning CT and used for target delineation and a dedicated 3T MRI scan at the time of planning was fused with the CT for hippocampus delineation. Methods and Materials: Twenty (20) patients were identified, and each patient underwent a radiotherapy planning CT scan and 2 MRI scans. Introduction: We assessed the feasibility of hippocampal sparing in adults with primary brain tumors using Intensity Modulated Proton Therapy (IMPT) and compared this with Intensity Modulated Radiotherapy (IMRT) and 3D-Conformal Radiotherapy (3DCRT). ![]()
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