Document Type
Article
Publication Date
7-6-2026
Abstract
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.
Recommended Citation
Chen, Anthony; Shah, Ryan; Shi, William; Urman, Noa; Shapira, Nadav; Avgeropoulos, Nicholas; Conlon, Patrick; Mookerjee, Neil; and Shi, Wenyin, "Feasibility Evaluation of Tumor Treating Fields for Brainstem Gliomas" (2026). Department of Radiation Oncology Faculty Papers. Paper 238.
https://jdc.jefferson.edu/radoncfp/238
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
42406140
Language
English
Comments
This article is the author’s final published version in Journal of Neuro-Oncology, Volume 178, Issue 3, 2026, Article number 91.
The published version is available at https://doi.org/10.1007/s11060-026-05697-y. Copyright © The Author(s) 2026.