ESTRO 2024 - Abstract Book

S6024

RTT - Treatment planning, OAR and target definitions

ESTRO 2024

Overall protocol compliance for planning within the ATNEC trial has remained consistently high at participating centres over the duration of the trial, with 97% and 50% of plans satisfying all mandatory and optimal constraints, respectively. Feedback was provided to centres delivering sub-optimal plans. Data from this interim analysis suggest a less intensive retrospective review schedule may be implemented going forward, and 1 in 10 cases requiring evaluation for monitoring compliance is proposed.

Keywords: Protocol compliance, radiotherapy, breast cancer

3036

Proffered Paper

Function-adapted radiotherapy planning for language-eloquent high-grade glioma.

Malin L Tröndle 1 , Martin Misslbeck 1 , Sarah Stefanowicz 1 , Enrike Rosenkranz 2 , Leonie Kram 3,4 , Maximilian J Schwendner 5,4 , Nico Sollmann 6 , Carolina Bernauer 1,3 , Arthur Wagner 3 , Sebastian Ille 3,4 , Bernhard Meyer 3 , Stephanie E Combs 1 , Sandro M Krieg 3,4 , Christian D Diehl 1 1 School of Medicine, Klinikum rechts der Isar, Technical University of Munich (TUM), Department of Radiation Oncology, Munich, Germany. 2 School of Medicine, Klinikum rechts der Isar, Technical University of Munich (TUM), Departmen of Diagnostic and Interventional Neuroradiologyt of, Munich, Germany. 3 School of Medicine, Klinikum rechts der Isar, Technical University of Munich (TUM), Department of Neurosurgery, Munich, Germany. 4 University Hospital Heidelberg, Department of Neurosurgery, Heidelberg, Germany. 5 School of Medicine, Klinikum rechts der Isar, Technical University of Munich (TUM), Department of Neurosurgeryation Oncology, Munich, Germany. 6 University Hospital Ulm, Departmen of Diagnostic and Interventional Neuroradiologyt of, Ulm, Germany In the trimodal treatment concept for high-grade gliomas (HGG), preservation of motor and language function is crucial for prognosis, quality of life and patient satisfaction. In particular, preservation of language function is important for patients in their social life as well as in their communication with healthcare professionals in therapy and rehabilitation. In neurosurgery functional mapping of the subcortical language tracts is increasingly applied for better preserving language during resection. In opposite, language-eloquent tracts have not been considered as an organ at risk (OAR) in radiotherapy planning so far. However, NTCP model-based constraints for dose-dependent and clinically relevant damage to subcortical white matter tracts have been recently proposed for doses > 20 Gy 1 . In this study, we integrated retrospectively FT-based language networks into RT planning of HGG and evaluated them dosimetrically in the sense of a feasibility analysis. Purpose/Objective:

Material/Methods:

Preoperative navigated transcranial magnetic stimulation (nTMS) language mapping was performed to identify individual language-relevant cortical areas and we subsequently used as seed-regions for diffusion tensor imaging (DTI)-based fiber tracking (DTI-FTTMS) of the functional left-hemispheric language network. This comprised the