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NovoTTF™-100A系统(肿瘤治疗电场)用于胶质母细胞瘤的换能器阵列布局规划:一项NovoTAL™系统用户研究

NovoTTF™-100A System (Tumor Treating Fields) transducer array layout planning for glioblastoma: a NovoTAL™ system user study.

作者信息

Chaudhry Aafia, Benson Laura, Varshaver Michael, Farber Ori, Weinberg Uri, Kirson Eilon, Palti Yoram

机构信息

Medical Affairs, Novocure Ltd., New York, NY, USA.

Technical Operations, Novocure Ltd., 195 Commerce Way, Portsmouth, NH, USA.

出版信息

World J Surg Oncol. 2015 Nov 11;13:316. doi: 10.1186/s12957-015-0722-3.

Abstract

BACKGROUND

Optune™, previously known as the NovoTTF-100A System™, generates Tumor Treating Fields (TTFields), an effective anti-mitotic therapy for glioblastoma. The system delivers intermediate frequency, alternating electric fields to the supratentorial brain. Patient therapy is personalized by configuring transducer array layout placement on the scalp to the tumor site using MRI measurements and the NovoTAL System. Transducer array layout mapping optimizes therapy by maximizing electric field intensity to the tumor site. This study evaluated physician performance in conducting transducer array layout mapping using the NovoTAL System compared with mapping performed by the Novocure in-house clinical team.

METHODS

Fourteen physicians (7 neuro-oncologists, 4 medical oncologists, and 3 neurosurgeons) evaluated five blinded cases of recurrent glioblastoma and performed head size and tumor location measurements using a standard Digital Imaging and Communications in Medicine reader. Concordance with Novocure measurement and intra- and inter-rater reliability were assessed using relevant correlation coefficients. The study criterion for success was a concordance correlation coefficient (CCC) >0.80.

RESULTS

CCC for each physician versus Novocure on 20 MRI measurements was 0.96 (standard deviation, SD ± 0.03, range 0.90-1.00), indicating very high agreement between the two groups. Intra- and inter-rater reliability correlation coefficients were similarly high: 0.83 (SD ±0.15, range 0.54-1.00) and 0.80 (SD ±0.18, range 0.48-1.00), respectively.

CONCLUSIONS

This user study demonstrated an excellent level of concordance between prescribing physicians and Novocure in-house clinical teams in performing transducer array layout planning. Intra-rater reliability was very high, indicating reproducible performance. Physicians prescribing TTFields, when trained on the NovoTAL System, can independently perform transducer array layout mapping required for the initiation and maintenance of patients on TTFields therapy.

摘要

背景

Optune™(以前称为NovoTTF - 100A系统™)可产生肿瘤治疗电场(TTFields),这是一种治疗胶质母细胞瘤的有效抗有丝分裂疗法。该系统向幕上脑区输送中频交变电场。通过使用MRI测量和NovoTAL系统将头皮上的换能器阵列布局放置配置到肿瘤部位,实现患者治疗的个性化。换能器阵列布局映射通过最大化肿瘤部位的电场强度来优化治疗。本研究评估了医生使用NovoTAL系统进行换能器阵列布局映射的表现,并与诺华致愈(Novocure)内部临床团队进行的映射进行比较。

方法

14名医生(7名神经肿瘤学家、4名医学肿瘤学家和3名神经外科医生)评估了5例复发性胶质母细胞瘤的盲法病例,并使用标准的医学数字成像和通信阅读器进行头围和肿瘤位置测量。使用相关相关系数评估与诺华致愈测量的一致性以及评分者内和评分者间的可靠性。成功的研究标准是一致性相关系数(CCC)>0.80。

结果

每位医生与诺华致愈在20次MRI测量上的CCC为0.96(标准差,SD±0.03,范围0.90 - 1.00),表明两组之间具有非常高的一致性。评分者内和评分者间的可靠性相关系数同样很高:分别为0.83(SD±0.15,范围0.54 - 1.00)和0.80(SD±0.18,范围0.48 - 1.00)。

结论

这项用户研究表明,在进行换能器阵列布局规划时,开处方的医生与诺华致愈内部临床团队之间具有出色的一致性水平。评分者内可靠性非常高,表明表现具有可重复性。接受过NovoTAL系统培训的开处方使用TTFields的医生可以独立进行启动和维持患者TTFields治疗所需的换能器阵列布局映射。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5279/4642621/f6a4cc64db97/12957_2015_722_Fig1_HTML.jpg

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