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Purpose <p>Tumor treating fields (TTFields) are FDA-approved for supratentorial glioblastoma, but feasibility in infratentorial tumors remains poorly defined. This simulation study evaluated TTFields dose in brainstem gliomas using patient-specific modeling with scalp-only transducer arrays.</p> Methods <p>MRI and CT imaging from seven patients with brainstem gliomas were used for TTFields planning with MAXPOINT<sup>®</sup> (Novocure, Switzerland). Clinical target volume (CTV) was defined as enhancing tumor on T1 post-contrast MRI (Gross tumor volume, GTV) plus a 3&#xa0;mm peritumoral expansion. The platform optimized scalp-only array layouts, and finite element calculations generated maps of local minimum field intensity (LMiFI, V/cm) and local minimum power density (LMiPD, mW/cm³). Values were compared against a standard, unplanned layout using one-sided paired t-tests, with LMiFI ≥ 1.0&#xa0;V/cm as a therapeutic reference.</p> Results <p>MAXPOINT-optimized layouts achieved significantly higher LMiFI than the standard layout across all regions (all <i>p</i> ≤ 0.019). GTV median LMiFI was 1.1 vs. 1.0&#xa0;V/cm (<i>p</i> = 0.019). CTV median LMiFI was 1.1 vs. 1.0&#xa0;V/cm (<i>p</i> = 0.002). Brainstem median LMiFI was 1.3 vs. 1.1&#xa0;V/cm (<i>p</i> = 0.002). Posterior fossa showed the largest difference: median LMiFI 1.5 vs. 1.2&#xa0;V/cm (<i>p</i> &lt; 0.001). All optimized LMiFI values met or exceeded the therapeutic reference. LMiPD was also significantly higher with MAXPOINT<sup>®</sup> across all regions (all <i>p</i> ≤ 0.006).</p> Conclusion <p>This simulation study demonstrates that patient-specific modeling can achieve favorable TTFields intensities in brainstem gliomas using scalp-only arrays, supporting prospective clinical evaluation for infratentorial tumors.</p>

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Feasibility evaluation of tumor treating fields for brainstem gliomas

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Anthony Yulin Chen,
  • Ryan Shah,
  • William Shi,
  • Noa Urman,
  • Nadav Shapira,
  • Nicholas Avgeropoulos,
  • Patrick Conlon,
  • Neil Mookerjee,
  • Wenyin Shi

摘要

Purpose

Tumor treating fields (TTFields) are FDA-approved for supratentorial glioblastoma, but feasibility in infratentorial tumors remains poorly defined. This simulation study evaluated TTFields dose in brainstem gliomas using patient-specific modeling with scalp-only transducer arrays.

Methods

MRI and CT imaging from seven patients with brainstem gliomas were used for TTFields planning with MAXPOINT® (Novocure, Switzerland). Clinical target volume (CTV) was defined as enhancing tumor on T1 post-contrast MRI (Gross tumor volume, GTV) plus a 3 mm peritumoral expansion. The platform optimized scalp-only array layouts, and finite element calculations generated maps of local minimum field intensity (LMiFI, V/cm) and local minimum power density (LMiPD, mW/cm³). Values were compared against a standard, unplanned layout using one-sided paired t-tests, with LMiFI ≥ 1.0 V/cm as a therapeutic reference.

Results

MAXPOINT-optimized layouts achieved significantly higher LMiFI than the standard layout across all regions (all p ≤ 0.019). GTV median LMiFI was 1.1 vs. 1.0 V/cm (p = 0.019). CTV median LMiFI was 1.1 vs. 1.0 V/cm (p = 0.002). Brainstem median LMiFI was 1.3 vs. 1.1 V/cm (p = 0.002). Posterior fossa showed the largest difference: median LMiFI 1.5 vs. 1.2 V/cm (p < 0.001). All optimized LMiFI values met or exceeded the therapeutic reference. LMiPD was also significantly higher with MAXPOINT® across all regions (all p ≤ 0.006).

Conclusion

This simulation study demonstrates that patient-specific modeling can achieve favorable TTFields intensities in brainstem gliomas using scalp-only arrays, supporting prospective clinical evaluation for infratentorial tumors.