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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/83026完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 曾文毅(Wen-Yih Isaac Tseng) | |
| dc.contributor.author | Yin-Yin Chiang | en |
| dc.contributor.author | 江盈瑩 | zh_TW |
| dc.date.accessioned | 2022-11-25T08:05:29Z | - |
| dc.date.copyright | 2021-11-09 | |
| dc.date.issued | 2021 | |
| dc.date.submitted | 2021-10-27 | |
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Niyazi M, Brada M, Chalmers AJ, et al. ESTRO-ACROP guideline 'target delineation of glioblastomas'. Radiother Oncol. 2016;118(1):35-42. 12. Kageji T, Nagahiro S, Uyama S, et al. Histopathological findings in autopsied glioblastoma patients treated by mixed neutron beam BNCT. J Neurooncol. 2004;68(1):25-32. 13. Shen S, Feng S, Liu H, Jiang J, Yu X. Associations of histological and molecular alterations with invasion of the corpus callosum in gliomas. Acta Neurochirurgica. 2020;162(7):1691-1699. 14. Chen KT, Wu TW, Chuang CC, et al. Corpus callosum involvement and postoperative outcomes of patients with gliomas. J Neurooncol. 2015;124(2):207-214. 15. Cai X, Qin JJ, Hao SY, et al. Clinical characteristics associated with the intracranial dissemination of gliomas. Clin Neurol Neurosurg. 2018;166:141146. 16. Opoku-Darko M, Amuah JE, Kelly JJP. Surgical Resection of Anterior and Posterior Butterfly Glioblastoma. World Neurosurgery. 2018;110:e612-e620. 17. Kruser TJ, Bosch WR, Badiyan SN, et al. NRG brain tumor specialists consensus guidelines for glioblastoma contouring. J Neurooncol. 2019;143(1):157-166. 18. Farace P, Giri MG, Meliado G, et al. Clinical target volume delineation in glioblastomas: pre-operative versus post-operative/pre-radiotherapy MRI. Br J Radiol. 2011;84(999):271-278. 19. Linhares P, Carvalho B, Figueiredo R, Reis RM, Vaz R. Early Pseudoprogression following Chemoradiotherapy in Glioblastoma Patients: The Value of RANO Evaluation. J Oncol. 2013;2013:690585. 20. Wen PY, Macdonald DR, Reardon DA, et al. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28(11):1963-1972. 21. Gerstner ER, Chen P-J, Wen PY, Jain RK, Batchelor TT, Sorensen G. Infiltrative patterns of glioblastoma spread detected via diffusion MRI after treatment with cediranib. Neuro-Oncology. 2010;12(5):466-472. 22. Yan J-L, Li C, Boonzaier NR, et al. Multimodal MRI characteristics of the glioblastoma infiltration beyond contrast enhancement. Ther Adv Neurol Disord. 2019;12:1756286419844664-1756286419844664. 23. Guo L, Wang G, Feng Y, et al. Diffusion and perfusion weighted magnetic resonance imaging for tumor volume definition in radiotherapy of brain tumors. Radiation Oncology. 2016;11(1):123. 24. Yu CS, Li KC, Xuan Y, Ji XM, Qin W. Diffusion tensor tractography in patients with cerebral tumors: A helpful technique for neurosurgical planning and postoperative assessment. European Journal of Radiology. 2005;56(2):197-204. 25. Torres IJ, Mundt AJ, Sweeney PJ, et al. A longitudinal neuropsychological study of partial brain radiation in adults with brain tumors. Neurology. 2003;60(7):1113-1118. 26. Kleinberg L, Wallner K, Malkin MG. Good performance status of long-term disease-free survivors of intracranial gliomas. Int J Radiat Oncol Biol Phys. 1993;26(1):129-133. 27. Tsien C, Gomez-Hassan D, Ten Haken RK, et al. Evaluating changes in tumor volume using magnetic resonance imaging during the course of radiotherapy treatment of high-grade gliomas: Implications for conformal dose-escalation studies. International Journal of Radiation Oncology, Biology, Physics. 2005;62(2):328-332. 28. Yang Z, Zhang Z, Wang X, et al. Intensity-modulated radiotherapy for gliomas:dosimetric effects of changes in gross tumor volume on organs at risk and healthy brain tissue. Onco Targets Ther. 2016;9:3545-3554. 29. McDonald MW, Shu H-KG, Curran WJ, Crocker IR. Pattern of Failure After Limited Margin Radiotherapy and Temozolomide for Glioblastoma. International Journal of Radiation Oncology*Biology*Physics. 2011;79(1):130136. 30. Dobelbower MC, Burnett Iii OL, Nordal RA, et al. Patterns of failure for glioblastoma multiforme following concurrent radiation and temozolomide. J Med Imaging Radiat Oncol. 2011;55(1):77-81. 31. Badiyan SN, Markovina S, Simpson JR, et al. Radiation Therapy Dose Escalation for Glioblastoma Multiforme in the Era of Temozolomide. International Journal of Radiation Oncology, Biology, Physics. 2014;90(4):877885. 32. Wegner RE, Abel S, Horne ZD, et al. National trends in radiation dose escalation for glioblastoma. Radiat Oncol J. 2019;37(1):13-21. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/83026 | - |
| dc.description.abstract | "背景 胼胝體侵犯是惡性神經膠質母細胞腦瘤的不良預後因子。常見腫瘤經由胼胝體順著解剖構造侵犯對側或前後鄰接其他腦區域。本研究期望能客觀量測腫瘤侵犯的範圍以供放射治療靶區界定的參考。 方法 針對經過標準手術、輔助放射線治療、化療，並且治療後併有局部復發的胼胝體侵犯神經膠質母細胞瘤病患進行回顧性研究分析。以術後、復發時的磁振造影匯入放射治療計畫系統進行影像對位。本研究使用兩種方式進行量測：(1) 直接測量：測量腫瘤邊緣在胼胝體與非胼胝體方向上復發並移動的距離；(2) 間接評估：輪廓勾畫術後殘存腫瘤與腫瘤術後空腔並依放射治療常規給予一定距離的外擴邊界作為靶區參考 (0.5、1.0、1.5公分依此類推的靶區)。再疊合復發時的磁振造影影像與靶區做比較，紀錄復發的腫瘤超越了哪個距離的靶區作為評估。另外依據前兩種量測分析結果，針對本研究收錄之胼胝體侵犯的病人制定探索性的個人化靶區建議。統計分析方法:距離量測比較，使用成對樣本t檢定來比較同一病人的兩種方向(胼胝體與非胼胝體方向)。 研究結果 自2014年01月至2020年07月，有40位病患進入分析，追蹤中位時間為17.9個月。胼胝體復發距離量測中位數為1.55公分而非胼胝體方向為0.53公分，兩方向有顯著差異 (p = 0.023)。在間接評估中，超出均勻外擴邊界的靶區的人數在胼胝體方向各為0.5公分：30人 (75.0%),；1.0公分：19人(47.5%)；1.5公分：5人(12.5%)；2.0公分：3人(7.5%)；2.5公分：1人(2.5%)。在非胼胝體方向各為0.5公分：10人 (25.0%),；1.0公分：3人(7.5%)；1.5公分：0人(0%)；2.0公分：0人(0%)；2.5公分：0人(0%)沒有病患在非胼胝體方向超越1公分的均勻外擴邊界，反之，有近半的病患在胼胝體方向超越1公分的均勻外擴邊界。 結論 胼胝體侵犯的神經膠質母細胞腦瘤發生腫瘤局部惡化復發時，在沿著胼胝體方向上的惡化復發距離較遠。對這群預後不佳的高風險病人應該依據其腫瘤復發特性與神經解剖構造關聯，給予獨有的放射治療靶區建議以期將放射線照射集中於高風險區域。 " | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-25T08:05:29Z (GMT). No. of bitstreams: 1 U0001-2610202119081100.pdf: 1927810 bytes, checksum: 649f3fe892f9fc237cfdf7e301e14650 (MD5) Previous issue date: 2021 | en |
| dc.description.tableofcontents | CONTENTS 中文摘要 i ABSTRACT iii CONTENTS vi LIST OF FIGURES viii LIST OF TABLES ix INTRODUCTION 10 1.1. Background 10 1.1.1. Current treatment modalities for glioblastoma 10 1.1.2. Limitations of current treatment 10 1.1.3. Infiltration of tumor cells along neural fiber tracts 10 1.2. Clinical target volume of GBM 10 1.2.1. American and European guidelines for target delineation and margin expansion 10 1.2.2 Treatment limitations of GBM with CC involvement 11 1.3. Motivation and objective of the study 12 MATERIALS AND METHODS 13 2.1. Participants and study design 13 2.1.1. Patient eligibility 13 2.1.2. Inclusion and exclusion criteria 13 2.1.3. Treatment approach 14 2.2. Imaging analysis 15 2.2.1 MRI examinations and follow-up 15 2.2.2. TPS and image registration 17 2.3. Analysis of tumor progression 17 2.3.1 Direct measurement of the extent of tumor migration 17 2.3.2 Indirect evaluation of the extent of tumor migration 18 2.4. Statistical analysis 21 2.5. Individualized margin expansion 21 RESULTS 23 3.1. Patient characteristics 23 3.2. Tumor migration distance: Direct measurement 25 3.3. Tumor migration distance: Indirect evaluation 27 3.4. Case demonstration 29 3.5. IME 32 DISCUSSION 35 4.1. Novelty and impact of the clinical investigation 35 4.2. Potential application of IME in RT 36 4.3. Decreased irradiated brain volume 39 4.4. Implication for dose escalation 40 4.5. Limitations 41 CONCLUSION 43 REFERENCE 44 LIST OF FIGURES Figure 1. Illustration of direct and indirect measurement.20 Figure 2 Progression pattern of selected cases of patients with glioblastoma and corpus callosum invasion.30 Figure 3 Analysis of the CTVUME and CTVIME.33 Figure 4 Analysis of progressive tumors on the MRILR overlapped with the CTVUME and CTVIME.34 LIST OF TABLES Table 1 Characteristics of the study patients 24 Table 2 Measurement of migration distance: direct measurement 26 Table 3 Measurement of migration extent: indirect evaluation 28 Table 4 Survival and progression patterns for corpus callosum-involved patients in current and published studies 38 | |
| dc.language.iso | en | |
| dc.subject | 磁振造影 | zh_TW |
| dc.subject | 放射線治療 | zh_TW |
| dc.subject | 神經膠質母細胞瘤 | zh_TW |
| dc.subject | 臨床靶區 | zh_TW |
| dc.subject | 個人化放療靶區輪廓勾畫 | zh_TW |
| dc.subject | Glioblastoma | en |
| dc.subject | Clinical target volume | en |
| dc.subject | Magnetic resonance imaging | en |
| dc.subject | Individualized treatment | en |
| dc.subject | Radiotherapy | en |
| dc.title | 分析神經膠質母細胞瘤併胼胝體侵犯之惡化型態發展個人化放射線治標把描繪 | zh_TW |
| dc.title | Analyzing the Progression Patterns of Glioblastoma With Corpus Callosum Invasion to Develop Individualized Radiotherapy Target Delineation | en |
| dc.date.schoolyear | 109-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.author-orcid | 0000-0002-9288-7758 | |
| dc.contributor.coadvisor | 梁祥光(Hsiang-Kuang Tony Liang) | |
| dc.contributor.oralexamcommittee | 吳文超(Hsin-Tsai Liu),陳中明(Chih-Yang Tseng) | |
| dc.subject.keyword | 放射線治療,神經膠質母細胞瘤,磁振造影,臨床靶區,個人化放療靶區輪廓勾畫, | zh_TW |
| dc.subject.keyword | Radiotherapy,Glioblastoma,Magnetic resonance imaging,Clinical target volume,Individualized treatment, | en |
| dc.relation.page | 51 | |
| dc.identifier.doi | 10.6342/NTU202104270 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2021-10-27 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 醫療器材與醫學影像研究所 | zh_TW |
| dc.date.embargo-lift | 2023-12-31 | - |
| 顯示於系所單位： | 醫療器材與醫學影像研究所 | |
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