TP1 Treatment of meningeoma with helium, proton and carbon ions: Optimization of treatment planning, establishment of study concepts and in vivo verification
The goal of this project is to develop novel concepts for treatment with particle therapy as well as in vivo verification of skull base tumors with special focus on low- and high grade meningiomas.
The optimization of existing treatment options will be first of all investigated by means of treatment plan comparisons of the already applied proton and carbon ion beams with potentially benficial helium beams.
Special emphasis will be given to the possibility of reducing toxicities and radiation induced risks, which could in turn be connected to dose escalation studies. These comparisons will not only involve absorbed and biological RBE-weighted dose as provided by available TPSs, but will also include detailed comparison of relevant quantities such as dose-averaged LET and neutron dose which may be provided by dedicated Monte Carlo simulations. Moreover, the clinical feasibility of high dose conformality with reduced burden to surrounding critical structures will be addressed via prospective application of post-irradiation PET-based treatment verification within the framework of the MIRANDA IRB-approved clinical study.
Patient undergoing a PET/CT measurement after scanned ion irradiation at HIT.
The patient was treated for a primary brain tumor with a carbon ion boost. The top panel depicts the dose planned by the commercial TPS overlaid onto the planning CT in axial and sagittal views. The bottom panel depicts the PET image acquired ca. 8 minutes after irradiation and overlaid onto the control CT data, merged and visualised approximately in the same views as the top row. (S. Combs et al. 2012, BMC Cancer)
Multifocal diffusely spreading atypical meningioma in a 55-year-old woman.
Contrast-agent enhanced CT and MRI scan were fused with a DOTATOC-PET/CT examination and used to calculate a two beam carbon ion radiotherapy plan. (Rieken et al. 2012, Radiat Oncol)
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Combs SE, Welzel T, Habermehl D, Rieken S, Dittmar JO, Kessel K, Jäkel O, Haberkorn U, Debus J. Prospective evaluation of early treatment outcome in patients with meningiomas treated with particle therapy based on target volume definition with MRI and 68Ga-DOTATOC-PET. Acta Oncol. 2013 Apr; 52(3):514-20.
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Rieken S, Habermehl D, Nikoghosyan A, Jensen A, Haberer T, Jäkel O, Münter MW, Welzel T, Debus J and Combs SE. Assessment of early toxicity and response in patients treated with proton and carbon ion therapy at the Heidelberg Ion Therapy Center (HIT) using the rasterscanning technique. Int J Radiat Oncol Biol Phys. 2011 Dec 1;81(5):793-801.
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