%0 Journal Article
%A Piroth, M.D.
%A Pinkawa, M.
%A Holy, R.
%A Klotz, J.
%A Schaar, S.
%A Stoffels, G.
%A Galldiks, N.
%A Coenen, H.H.
%A Kaiser, H.J.
%A Langen, K.J.
%A Eble, M.J.:
%T Integrated boost IMRT with FET-PET-adapted local dose escalation in glioblastomas: Results of a prospective phase II study
%J Strahlentherapie und Onkologie
%V 188
%@ 0179-7158
%C Berlin
%I Springer Medizin
%M PreJuSER-20427
%P 334 - 339
%D 2012
%Z Record converted from VDB: 12.11.2012
%X 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.
%K Adult
%K Aged
%K Brain: radiation effects
%K Chemoradiotherapy, Adjuvant
%K Combined Modality Therapy
%K Disease-Free Survival
%K Dose Fractionation
%K Female
%K Follow-Up Studies
%K Glioblastoma: drug therapy
%K Glioblastoma: mortality
%K Glioblastoma: pathology
%K Glioblastoma: radiotherapy
%K Glioblastoma: surgery
%K Humans
%K Magnetic Resonance Imaging
%K Male
%K Mental Status Schedule
%K Middle Aged
%K Positron-Emission Tomography: methods
%K Prospective Studies
%K Quality of Life
%K Radiation Injuries: etiology
%K Radiotherapy Planning, Computer-Assisted: methods
%K Radiotherapy, Intensity-Modulated: methods
%K Supratentorial Neoplasms: drug therapy
%K Supratentorial Neoplasms: mortality
%K Supratentorial Neoplasms: pathology
%K Supratentorial Neoplasms: radiotherapy
%K Supratentorial Neoplasms: surgery
%K Tyrosine: analogs & derivatives
%K Tyrosine: therapeutic use
%K O-(2-((18)F)fluoroethyl)-L-tyrosine (NLM Chemicals)
%K Tyrosine (NLM Chemicals)
%K J (WoSType)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:22349712
%U <Go to ISI:>//WOS:000301776900005
%R 10.1007/s00066-011-0060-5
%U https://juser.fz-juelich.de/record/20427