TY  - JOUR
AU  - Piroth, M.D.
AU  - Pinkawa, M.
AU  - Holy, R.
AU  - Klotz, J.
AU  - Schaar, S.
AU  - Stoffels, G.
AU  - Galldiks, N.
AU  - Coenen, H.H.
AU  - Kaiser, H.J.
AU  - Langen, K.J.
AU  - Eble, M.J.:
TI  - Integrated boost IMRT with FET-PET-adapted local dose escalation in glioblastomas: Results of a prospective phase II study
JO  - Strahlentherapie und Onkologie
VL  - 188
SN  - 0179-7158
CY  - Berlin
PB  - Springer Medizin
M1  - PreJuSER-20427
SP  - 334 - 339
PY  - 2012
N1  - Record converted from VDB: 12.11.2012
AB  - 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.
KW  - Adult
KW  - Aged
KW  - Brain: radiation effects
KW  - Chemoradiotherapy, Adjuvant
KW  - Combined Modality Therapy
KW  - Disease-Free Survival
KW  - Dose Fractionation
KW  - Female
KW  - Follow-Up Studies
KW  - Glioblastoma: drug therapy
KW  - Glioblastoma: mortality
KW  - Glioblastoma: pathology
KW  - Glioblastoma: radiotherapy
KW  - Glioblastoma: surgery
KW  - Humans
KW  - Magnetic Resonance Imaging
KW  - Male
KW  - Mental Status Schedule
KW  - Middle Aged
KW  - Positron-Emission Tomography: methods
KW  - Prospective Studies
KW  - Quality of Life
KW  - Radiation Injuries: etiology
KW  - Radiotherapy Planning, Computer-Assisted: methods
KW  - Radiotherapy, Intensity-Modulated: methods
KW  - Supratentorial Neoplasms: drug therapy
KW  - Supratentorial Neoplasms: mortality
KW  - Supratentorial Neoplasms: pathology
KW  - Supratentorial Neoplasms: radiotherapy
KW  - Supratentorial Neoplasms: surgery
KW  - Tyrosine: analogs & derivatives
KW  - Tyrosine: therapeutic use
KW  - O-(2-((18)F)fluoroethyl)-L-tyrosine (NLM Chemicals)
KW  - Tyrosine (NLM Chemicals)
KW  - J (WoSType)
LB  - PUB:(DE-HGF)16
C6  - pmid:22349712
UR  - <Go to ISI:>//WOS:000301776900005
DO  - DOI:10.1007/s00066-011-0060-5
UR  - https://juser.fz-juelich.de/record/20427
ER  -