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@ARTICLE{Piroth:20427,
author = {Piroth, M.D. and Pinkawa, M. and Holy, R. and Klotz, J. and
Schaar, S. and Stoffels, G. and Galldiks, N. and Coenen,
H.H. and Kaiser, H.J. and Langen, K.J. and Eble, M.J.:},
title = {{I}ntegrated boost {IMRT} with {FET}-{PET}-adapted local
dose escalation in glioblastomas: {R}esults of a prospective
phase {II} study},
journal = {Strahlentherapie und Onkologie},
volume = {188},
issn = {0179-7158},
address = {Berlin},
publisher = {Springer Medizin},
reportid = {PreJuSER-20427},
pages = {334 - 339},
year = {2012},
note = {Record converted from VDB: 12.11.2012},
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.},
keywords = {Adult / Aged / Brain: radiation effects /
Chemoradiotherapy, Adjuvant / Combined Modality Therapy /
Disease-Free Survival / Dose Fractionation / Female /
Follow-Up Studies / Glioblastoma: drug therapy /
Glioblastoma: mortality / Glioblastoma: pathology /
Glioblastoma: radiotherapy / Glioblastoma: surgery / Humans
/ Magnetic Resonance Imaging / Male / Mental Status Schedule
/ Middle Aged / Positron-Emission Tomography: methods /
Prospective Studies / Quality of Life / Radiation Injuries:
etiology / Radiotherapy Planning, Computer-Assisted: methods
/ Radiotherapy, Intensity-Modulated: methods /
Supratentorial Neoplasms: drug therapy / Supratentorial
Neoplasms: mortality / Supratentorial Neoplasms: pathology /
Supratentorial Neoplasms: radiotherapy / Supratentorial
Neoplasms: surgery / Tyrosine: analogs $\&$ derivatives /
Tyrosine: therapeutic use /
O-(2-((18)F)fluoroethyl)-L-tyrosine (NLM Chemicals) /
Tyrosine (NLM Chemicals) / J (WoSType)},
cin = {INM-4 / INM-5 / INM-3},
ddc = {610},
cid = {I:(DE-Juel1)INM-4-20090406 / I:(DE-Juel1)INM-5-20090406 /
I:(DE-Juel1)INM-3-20090406},
pnm = {Funktion und Dysfunktion des Nervensystems (FUEK409) /
89572 - (Dys-)function and Plasticity (POF2-89572)},
pid = {G:(DE-Juel1)FUEK409 / G:(DE-HGF)POF2-89572},
shelfmark = {Oncology / Radiology, Nuclear Medicine $\&$ Medical
Imaging},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:22349712},
UT = {WOS:000301776900005},
doi = {10.1007/s00066-011-0060-5},
url = {https://juser.fz-juelich.de/record/20427},
}