Positioning Transclival Tumor-Treating Fields for the Treatment of Diffuse Intrinsic Pontine Gliomas.
Walid I B N EssayedCasey A JarvisJoshua D BernstockAnna SlingerlandJohn AlbaneseGregory K FriedmanOmar ArnaoutLissa BairdPublished in: Life (Basel, Switzerland) (2023)
Diffuse intrinsic pontine glioma (DIPG) carries an extremely poor prognosis, with 2-year survival rates of <10% despite the maximal radiation therapy. DIPG cells have previously been shown to be sensitive to low-intensity electric fields in vitro. Accordingly, we sought to determine if the endoscopic endonasal (EE) implantation of an electrode array in the clivus would be feasible for the application of tumor-treating fields (TTF) in DIPG. Anatomic constraints are the main limitation in pediatric EE approaches. In our Boston Children's Hospital's DIPG cohort, we measured the average intercarotid distance (1.68 ± 0.36 cm), clival width (1.62 ± 0.19 cm), and clival length from the base of the sella (1.43 ± 0.69 cm). Using a linear regression model, we found that only clival length and sphenoid pneumatization were significantly associated with age (R 2 = 0.568, p = 0.005 *; R 2 = 0.605, p = 0.0002 *). Critically, neither of these parameters represent limitations to the implantation of a device within the dimensions of those currently available. Our findings confirm that the anatomy present within this age group is amenable to the placement of a 2 × 1 cm electrode array in 94% of patients examined. Our work serves to demonstrate the feasibility of implantable transclival devices for the provision of TTFs as a novel adjunctive therapy for DIPG.
Keyphrases
- poor prognosis
- radiation therapy
- long non coding rna
- end stage renal disease
- low grade
- newly diagnosed
- ejection fraction
- chronic kidney disease
- induced apoptosis
- healthcare
- high throughput
- high grade
- young adults
- palliative care
- peritoneal dialysis
- high density
- heart rate
- squamous cell carcinoma
- mass spectrometry
- oxidative stress
- signaling pathway
- cell proliferation
- carbon nanotubes
- locally advanced
- emergency department
- blood pressure
- adverse drug
- rectal cancer
- single cell