title: Simultaneous integrated boost intensity-modulated radiotherapy in patients with high-grade gliomas.
abstract: OBJECTIVE
  We analyzed outcomes of simultaneous integrated boost (SIB) intensity-modulated radiotherapy (IMRT) in patients with high-grade gliomas, compared with a literature review.
  
  
  METHODS
  Forty consecutive patients (WHO grade III, 14 patients; grade IV, 26 patients) treated with SIB-IMRT were analyzed. A dose of 2.0 Gy was delivered to the planning target volume with a SIB of 0.4 Gy to the gross tumor volume with a total dose of 60 Gy to the gross tumor volume and 50 Gy to the planning target volume in 25 fractions during 5 weeks. Twenty patients received temozolomide chemotherapy.
  
  
  RESULTS
  At a median follow-up of 13.4 months (range, 3.7-55.9 months), median survival was 14.8 months. One- and 2-year survival rates were 78% and 65%, respectively, for patients with grade III tumors and 56% and 31%, respectively, for patients with grade IV tumors. Age (≤50 vs. >50), grade (III vs. IV), subtype (astrocytoma vs. oligodendroglioma or mixed), and a Zubrod performance score (0-1 vs. >2) were predictive of survival. Of 25 (63%) patients who had recurrences, 17 patients had local failure, 9 patients had regional failure, and 1 patient had distant metastasis. Toxicities were acceptable.
  
  
  CONCLUSIONS
  SIB-IMRT with the dose/fractionation used in this study is feasible and safe, with a survival outcome similar to the historical control. The shortening of treatment time by using SIB-IMRT may be of value, although further investigation is warranted to prove its survival advantage.
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea. kwancho@ncc.re.kr
authors.forename: Kwan Ho
authors.initials: KH
authors.lastname: Cho
authors.forename: Joo-Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Heon
authors.initials: H
authors.lastname: Yoo
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Shin
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Moon
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.forename: Kyung Hwan
authors.initials: KH
authors.lastname: Shin
authors.forename: Myonggeun
authors.initials: M
authors.lastname: Yoon
authors.forename: Doo-Hyun
authors.initials: DH
authors.lastname: Lee
authors.forename: Hong Ryull
authors.initials: HR
authors.lastname: Pyo
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001254:Astrocytoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D000077204:Temozolomide; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide