Feasibility evaluation of tumor treating fields for brainstem gliomas.

Authors

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

Published in

Journal of neuro-oncology. Volume 178. Issue 3. Jul 06, 2026. Epub Jul 06, 2026.

Abstract

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.
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.
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).
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.

PMID:
42406140
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.

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