title: Clinical significance of thallium-201 SPECT after postoperative radiotherapy in patients with glioblastoma multiforme.
abstract: 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.
authors.affiliation: Department of Radiology, University of the Ryukyus, School of Medicine, 207 Uehara, 903-0215, Nishihara-cho, Okinawa, Japan.
authors.forename: Gyo
authors.initials: G
authors.lastname: Iida
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Shogo
authors.initials: S
authors.lastname: Ishiuchi
authors.forename: Itaru
authors.initials: I
authors.lastname: Chiba
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Naofumi
authors.initials: N
authors.lastname: Katsuyama
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yoshii
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Murayama
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes
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