Hypofractionated intensity-modulated radiotherapy using simultaneous integrated boost technique with concurrent and adjuvant temozolomide for glioblastoma
| Autor: | Sang Min, Yoon, Jeong Hoon, Kim, Sang Joon, Kim, Shin Kwang, Khang, Seong Soo, Shin, Young Hyun, Cho, Eunjin, Jwa, Jin-Hong, Park, Seung Do, Ahn |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Cancer Research Kaplan-Meier Estimate Disease-Free Survival 030218 nuclear medicine & medical imaging Necrosis 03 medical and health sciences 0302 clinical medicine Temozolomide Humans Treatment Failure Antineoplastic Agents Alkylating Aged Brain Neoplasms Brain Chemoradiotherapy Adjuvant General Medicine Middle Aged Dacarbazine Treatment Outcome Oncology Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female Dose Fractionation Radiation Radiotherapy Intensity-Modulated Glioblastoma |
| Zdroj: | Tumori Journal. 99:480-487 |
| ISSN: | 2038-2529 0300-8916 |
| DOI: | 10.1177/030089161309900407 |
| Popis: | Aims and background We assessed the therapeutic efficacy of combined hypofractionated intensity-modulated radiotherapy with temozolomide in patients with primary glioblastoma. Methods and study design Thirty-nine patients with histologically confirmed glioblastoma were accrued. Using the simultaneous integrated boost technique, a dose of 50 Gy in 5-Gy fractions was applied to the gross tumor volume, together with 40 Gy in 4-Gy fractions and 30 Gy in 3-Gy fractions to the 1- and 2-cm margins from the gross tumor volume, respectively. Patients were also treated with concurrent temozolomide during intensity-modulated radiotherapy, followed by six cycles of adjuvant temozolomide. Results Median follow-up was 16.8 months (range, 4.3–54.3). Tumor progression was observed in 28 patients (71.8%), and the median time to progression was 6.8 months. Median survival was 16.8 months, and it was affected significantly by the extent of surgery. During adjuvant temozolomide treatment, 3 patients (9.7%) developed grade 3–4 hematologic or hepatic toxicity. Radiation necrosis developed in 7 patients (17.9%) and massive necrosis, requiring emergency surgery, in 1 patient (2.6%). Conclusions The regimen of hypofractionated intensity-modulated radiotherapy with temozolomide showed a relatively good outcome in patients with glioblastoma. Further studies are required to define the optimal fraction size for glioblastoma using this highly sophisticated radiation technique. |
| Databáze: | OpenAIRE |
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