Dose-accumulation analysis of target and organs at risk with clinical outcome after re-irradiation of diffuse midline glioma

Figures & data

Table 1. Re-irradiation of DMG.

ID	Gender/age	Tumour location	Time to progression (m)	Gy/F	Symptoms prior to re-irradiation	Clinical improvement 6 weeks after reRT*	Early toxicity after reRT	Time from reRT to death (m)
1	F/6	Pons	17	30/15	Tiredness, sialorre, cognitive affection, neurological affection	Yes	Fatigue, somnolence	5
2	M/6	Pons	8	27/9**	Headache, sight disturbance, neurological affection	No	Headache, affected speech	3
3	M/8	Thalamus	11	25/5	Neurological affection, pain	Yes	Skin erythema, light pain	4
4	F/6	Pons	9	30/10	Sight disturbance, neurological affection	Yes	Fatigue, headache	4
5	F/2	Pons	6	30/10	Headache, nausea, tiredness, sialorre, pain, neurological affection	Missing data	Missing data	4
6	M/12	Thalamus	8	24/12	Headache, tiredness, neurological affection, cognitive affection	Yes	None	10
7	F/13	Thalamus	13	30/10	Headache, tiredness, neurological affection, cognitive affection	Stable	Fatigue, sight disturbance	10

Age: age at diagnosis, F: female, M: male, Dx: diagnosis, y: years, m: months, Gy: gray, F: fractions.

*Clinical improvement defined as Yes/No/Stable/NA at 6 weeks post re-irradiation.

**Patient no. 2 never had his last fraction due to progression during re-irradiation.

Figure 1. The individual DVHs for two organs at risk (OAR), one OAR close to (brainstem) and one OAR (left eye) far from the CTV. The colours represent the individual patients. The y-axis is percentage of irradiated volume, and the x-axis is the absolute dose in gray (Gy). The dashed line represents the median DVH of all patients. (a) Dose to the brainstem from course 1, (b) dose to the brainstem from course 2. (c) Dose to the left eye from course 1. (d) Dose to the left eye from course 2. This figure shows how OAR close to the CTV received a high dose to a large volume compared to OAR further away from the CTV.

Figure 2. EQD₂ dose (Gy), each dot represents a patient and each colours represents a structure in the brain defined as an OAR. The colour code is shown in the legend. The dashed red line is equal to 60 Gy and represents the DNOG recommended D_max to the brainstem, chiasm, and optic nerves [9].

DNOG. DNOG Retningslinjer for strålebehandling. 2016.

 Google Scholar

Data availability statement

Data not available due to ethical/legal restrictions.