Clinical significance of thallium-201 SPECT after postoperative radiotherapy in patients with glioblastoma multiforme.
To assess the clinical significance of 201Tl-SPECT after postoperative radiotherapy in patients with glioblastoma multiforme (GM). Eighteen patients with macroscopically residual GM who underwent 201Tl-SPECT just after postoperative radiotherapy were analyzed. Fifteen patients (83%) received radiotherapy with a total dose of 60 Gy in conventional fractionation, and the remaining three patients were treated with 72 Gy with hyperfractionation schedules. Sixteen patients (89%) were treated with chemotherapy that consisted of procarbazine, nimustine (ACNU) and vincristine. Concerning 201Tl-SPECT, we calculated the radioactivity ratio of the tumors to contralateral normal brain (T/N ratio) on early and delayed images after 111 MBq 201Tl chloride injections. The median follow-up of all 18 patients was 14.7 months (range, 2.7-38.0 months). At the time of this analysis, 15 patients (83%) had died, and the 1-year overall survival and the median survival time were 67% and 16.2 months, respectively. Fifteen patients (83%) had disease recurrence, and the 1-year progression-free survival (PFS) rate and the median time to progression in all 18 patients were 29% and 7.6 months, respectively. Patients with a high early T/N ratio had a significantly poorer PFS than those with a low T/N ratio (P = 0.0131). On univariate analysis, early T/N ratio alone had a significant impact on PFS, and on mutivariate analysis, early T/N ratio alone was a significant prognostic factor for PFS. 201Tl-SPECT after postoperative radiotherapy was predictive of PFS in patients with macroscopically residual GM.
Iida
Gyo
G
Department of Radiology, University of the Ryukyus, School of Medicine, 207 Uehara, 903-0215, Nishihara-cho, Okinawa, Japan.
Ogawa
Kazuhiko
K
Ishiuchi
Shogo
S
Chiba
Itaru
I
Watanabe
Takashi
T
Katsuyama
Naofumi
N
Yoshii
Yoshihiko
Y
Murayama
Sadayuki
S
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000532:radiotherapy; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000532:radiotherapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011379:Prognosis; D019275:Radiopharmaceuticals; D018714:Radiotherapy, Adjuvant; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes
Nucl Med Commun. 1993 Dec;14(12):1071-8
8295762
Int J Radiat Oncol Biol Phys. 1994 Dec 1;30(5):1201-6
7961030
Neurol Res. 1994 Apr;16(2):93-6
7914007
Clin Nucl Med. 2001 Feb;26(2):119-24
11201468
Int J Clin Oncol. 2004 Feb;9(1):51-8
15162827
AJNR Am J Neuroradiol. 2000 May;21(5):901-9
10815666
Nat Rev Neurosci. 2007 Aug;8(8):610-22
17643088
J Neurosurg. 1978 Sep;49(3):333-43
355604
Ann Nucl Med. 1996 Feb;10(1):41-8
8814726
J Natl Cancer Inst. 1993 May 5;85(9):704-10
8478956
Semin Nucl Med. 2003 Apr;33(2):148-62
12756647
Curr Opin Oncol. 1998 May;10(3):175-8
9619351
Neuroimaging Clin N Am. 1999 Nov;9(4):651-69
10517938
Radiology. 1993 Oct;189(1):233-8
8372199
Br J Cancer. 2006 Oct 9;95(7):862-8
16953239
J Neurooncol. 2002 Aug;59(1):81-90
12222842
J Nucl Med. 2000 Jan;41(1):5-10
10647598
J Neurooncol. 1994;20(2):111-20
7807189
Clin Oncol (R Coll Radiol). 2004 Oct;16(7):494-500
15490813
J Clin Oncol. 1990 Jul;8(7):1277-80
2358840
Neurosurgery. 1994 Mar;34(3):396-401
8190213
Semin Oncol. 1994 Apr;21(2):162-71
8153662
Nucl Med Commun. 1993 Dec;14(12):1050-60
8295760
Radiother Oncol. 2002 Sep;64(3):259-73
12242114
Int J Radiat Oncol Biol Phys. 1998 Jan 1;40(1):51-5
9422557
J Nucl Med. 1993 Dec;34(12):2091-4
8254393
Semin Oncol. 2003 Dec;30(6 Suppl 19):10-4
14765378
Cancer Chemother Rep. 1966 Mar;50(3):163-70
5910392
Cancer. 1981 Feb 15;47(4):649-52
6164465
Kaku Igaku. 2002 Nov;39(4):519-25
12607240
Ann Nucl Med. 2006 May;20(4):287-94
16856572
Radiology. 2000 Nov;217(2):377-84
11058631
J Nucl Med. 1993 Dec;34(12):2085-9
8254391
J Clin Oncol. 2003 Oct 1;21(19):3559-65
12913097
Semin Oncol. 2003 Dec;30(6 Suppl 19):4-9
14765377
J Neurosurg. 1989 Sep;71(3):342-6
2549223
J Neurooncol. 2006 Jul;78(3):281-93
16554966