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000020427 084__ $$2WoS$$aOncology
000020427 084__ $$2WoS$$aRadiology, Nuclear Medicine & Medical Imaging
000020427 1001_ $$0P:(DE-HGF)0$$aPiroth, M.D.$$b0
000020427 245__ $$aIntegrated boost IMRT with FET-PET-adapted local dose escalation in glioblastomas: Results of a prospective phase II study
000020427 260__ $$aBerlin$$bSpringer Medizin$$c2012
000020427 300__ $$a334 - 339
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000020427 520__ $$aDose escalations above 60 Gy based on MRI have not led to prognostic benefits in glioblastoma patients yet. With positron emission tomography (PET) using [(18)F]fluorethyl-L-tyrosine (FET), tumor coverage can be optimized with the option of regional dose escalation in the area of viable tumor tissue.In a prospective phase II study (January 2008 to December 2009), 22 patients (median age 55 years) received radiochemotherapy after surgery. The radiotherapy was performed as an MRI and FET-PET-based integrated-boost intensity-modulated radiotherapy (IMRT). The prescribed dose was 72 and 60 Gy (single dose 2.4 and 2.0 Gy, respectively) for the FET-PET- and MR-based PTV-FET((72 Gy)) and PTV-MR((60 Gy)). FET-PET and MRI were performed routinely for follow-up. Quality of life and cognitive aspects were recorded by the EORTC-QLQ-C30/QLQ Brain20 and Mini-Mental Status Examination (MMSE), while the therapy-related toxicity was recorded using the CTC3.0 and RTOG scores.Median overall survival (OS) and disease-free survival (DFS) were 14.8 and 7.8 months, respectively. All local relapses were detected at least partly within the 95% dose volume of PTV-MR((60 Gy)). No relevant radiotherapy-related side effects were observed (excepted alopecia). In 2 patients, a pseudoprogression was observed in the MRI. Tumor progression could be excluded by FET-PET and was confirmed in further MRI and FET-PET imaging. No significant changes were observed in MMSE scores and in the EORTC QLQ-C30/QLQ-Brain20 questionnaires.Our dose escalation concept with a total dose of 72 Gy, based on FET-PET, did not lead to a survival benefit. Acute and late toxicity were not increased, compared with historical controls and published dose-escalation studies.
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000020427 650_2 $$2MeSH$$aAdult
000020427 650_2 $$2MeSH$$aAged
000020427 650_2 $$2MeSH$$aBrain: radiation effects
000020427 650_2 $$2MeSH$$aChemoradiotherapy, Adjuvant
000020427 650_2 $$2MeSH$$aCombined Modality Therapy
000020427 650_2 $$2MeSH$$aDisease-Free Survival
000020427 650_2 $$2MeSH$$aDose Fractionation
000020427 650_2 $$2MeSH$$aFemale
000020427 650_2 $$2MeSH$$aFollow-Up Studies
000020427 650_2 $$2MeSH$$aGlioblastoma: drug therapy
000020427 650_2 $$2MeSH$$aGlioblastoma: mortality
000020427 650_2 $$2MeSH$$aGlioblastoma: pathology
000020427 650_2 $$2MeSH$$aGlioblastoma: radiotherapy
000020427 650_2 $$2MeSH$$aGlioblastoma: surgery
000020427 650_2 $$2MeSH$$aHumans
000020427 650_2 $$2MeSH$$aMagnetic Resonance Imaging
000020427 650_2 $$2MeSH$$aMale
000020427 650_2 $$2MeSH$$aMental Status Schedule
000020427 650_2 $$2MeSH$$aMiddle Aged
000020427 650_2 $$2MeSH$$aPositron-Emission Tomography: methods
000020427 650_2 $$2MeSH$$aProspective Studies
000020427 650_2 $$2MeSH$$aQuality of Life
000020427 650_2 $$2MeSH$$aRadiation Injuries: etiology
000020427 650_2 $$2MeSH$$aRadiotherapy Planning, Computer-Assisted: methods
000020427 650_2 $$2MeSH$$aRadiotherapy, Intensity-Modulated: methods
000020427 650_2 $$2MeSH$$aSupratentorial Neoplasms: drug therapy
000020427 650_2 $$2MeSH$$aSupratentorial Neoplasms: mortality
000020427 650_2 $$2MeSH$$aSupratentorial Neoplasms: pathology
000020427 650_2 $$2MeSH$$aSupratentorial Neoplasms: radiotherapy
000020427 650_2 $$2MeSH$$aSupratentorial Neoplasms: surgery
000020427 650_2 $$2MeSH$$aTyrosine: analogs & derivatives
000020427 650_2 $$2MeSH$$aTyrosine: therapeutic use
000020427 650_7 $$00$$2NLM Chemicals$$aO-(2-((18)F)fluoroethyl)-L-tyrosine
000020427 650_7 $$055520-40-6$$2NLM Chemicals$$aTyrosine
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000020427 65320 $$2Author$$aDose escalation
000020427 65320 $$2Author$$aGlioblastoma
000020427 65320 $$2Author$$aRadiotherapy
000020427 65320 $$2Author$$aDose fractionation
000020427 7001_ $$0P:(DE-HGF)0$$aPinkawa, M.$$b1
000020427 7001_ $$0P:(DE-HGF)0$$aHoly, R.$$b2
000020427 7001_ $$0P:(DE-HGF)0$$aKlotz, J.$$b3
000020427 7001_ $$0P:(DE-HGF)0$$aSchaar, S.$$b4
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000020427 7001_ $$0P:(DE-Juel1)131777$$aLangen, K.J.$$b9$$uFZJ
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