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| Hauptseite > Publikationsdatenbank > Integrated boost IMRT with FET-PET-adapted local dose escalation in glioblastomas: Results of a prospective phase II study |
| Hauptseite > Publikationsdatenbank > Integrated boost IMRT with FET-PET-adapted local dose escalation in glioblastomas: Results of a prospective phase II study |
| Journal Article | PreJuSER-20427 |
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2012
Springer Medizin
Berlin
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Please use a persistent id in citations: doi:10.1007/s00066-011-0060-5
Abstract: Dose escalations above 60 Gy based on MRI have not led to prognostic benefits in glioblastoma patients yet. With positron emission tomography (PET) using [(18)F]fluorethyl-L-tyrosine (FET), tumor coverage can be optimized with the option of regional dose escalation in the area of viable tumor tissue.In a prospective phase II study (January 2008 to December 2009), 22 patients (median age 55 years) received radiochemotherapy after surgery. The radiotherapy was performed as an MRI and FET-PET-based integrated-boost intensity-modulated radiotherapy (IMRT). The prescribed dose was 72 and 60 Gy (single dose 2.4 and 2.0 Gy, respectively) for the FET-PET- and MR-based PTV-FET((72 Gy)) and PTV-MR((60 Gy)). FET-PET and MRI were performed routinely for follow-up. Quality of life and cognitive aspects were recorded by the EORTC-QLQ-C30/QLQ Brain20 and Mini-Mental Status Examination (MMSE), while the therapy-related toxicity was recorded using the CTC3.0 and RTOG scores.Median overall survival (OS) and disease-free survival (DFS) were 14.8 and 7.8 months, respectively. All local relapses were detected at least partly within the 95% dose volume of PTV-MR((60 Gy)). No relevant radiotherapy-related side effects were observed (excepted alopecia). In 2 patients, a pseudoprogression was observed in the MRI. Tumor progression could be excluded by FET-PET and was confirmed in further MRI and FET-PET imaging. No significant changes were observed in MMSE scores and in the EORTC QLQ-C30/QLQ-Brain20 questionnaires.Our dose escalation concept with a total dose of 72 Gy, based on FET-PET, did not lead to a survival benefit. Acute and late toxicity were not increased, compared with historical controls and published dose-escalation studies.
Keyword(s): Adult (MeSH) ; Aged (MeSH) ; Brain: radiation effects (MeSH) ; Chemoradiotherapy, Adjuvant (MeSH) ; Combined Modality Therapy (MeSH) ; Disease-Free Survival (MeSH) ; Dose Fractionation (MeSH) ; Female (MeSH) ; Follow-Up Studies (MeSH) ; Glioblastoma: drug therapy (MeSH) ; Glioblastoma: mortality (MeSH) ; Glioblastoma: pathology (MeSH) ; Glioblastoma: radiotherapy (MeSH) ; Glioblastoma: surgery (MeSH) ; Humans (MeSH) ; Magnetic Resonance Imaging (MeSH) ; Male (MeSH) ; Mental Status Schedule (MeSH) ; Middle Aged (MeSH) ; Positron-Emission Tomography: methods (MeSH) ; Prospective Studies (MeSH) ; Quality of Life (MeSH) ; Radiation Injuries: etiology (MeSH) ; Radiotherapy Planning, Computer-Assisted: methods (MeSH) ; Radiotherapy, Intensity-Modulated: methods (MeSH) ; Supratentorial Neoplasms: drug therapy (MeSH) ; Supratentorial Neoplasms: mortality (MeSH) ; Supratentorial Neoplasms: pathology (MeSH) ; Supratentorial Neoplasms: radiotherapy (MeSH) ; Supratentorial Neoplasms: surgery (MeSH) ; Tyrosine: analogs & derivatives (MeSH) ; Tyrosine: therapeutic use (MeSH) ; O-(2-((18)F)fluoroethyl)-L-tyrosine ; Tyrosine ; J ; Dose escalation (auto) ; Glioblastoma (auto) ; Radiotherapy (auto) ; Dose fractionation (auto)
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