title: Evaluation of helical tomotherapy in the treatment of high-grade gliomas near critical structures.
abstract: BACKGROUND
  Our purpose was to investigate the role of helical tomotherapy using a simultaneous integrated boost technique for the treatment of high-grade gliomas near intracranial critical structures.
  
  
  METHODS
  Of 27 patients treated with helical tomotherapy, 11 were eligible. Only patients whose tumors were within 0.5 cm of the optic chiasm, the optic nerve or the brainstem were included. The therapeutic approach was a simultaneous integrated boost, prescribing 66 and 60 Gy to the PTV1 and PTV2, respectively, in 30 fractions. All patients received concomitant temozolomide at a dose of 75 mg/m2 daily during radiation therapy.
  
  
  RESULTS
  Of the 11 patients considered, 3 patients (27%) died after 4 months from the completion of the combined treatment. Three patients (27%) presented local progression, and the median time to disease progression was 6 months (range, 1-12). Five patients (45%), at the time of this evaluation, did not have signs or symptoms of recurrence or progression of the disease. Acute toxicity, evaluated during radiochemotherapy, was minimal, with all patients experiencing RTOG grade 0 and grade 1 toxicity.
  
  
  CONCLUSIONS
  . Helical tomotherapy proved to be an effective and safe treatment modality, with an improvement of accuracy in delivery of high-dose radiotherapy despite the presence of nearby critical structures.
authors.affiliation: Department of Radiation Oncology, S Camillo-Forlanini Hospital, Rome, Italy. vdonato@scamilloforlanini.rm.it
authors.forename: Vittorio
authors.initials: V
authors.lastname: Donato
authors.forename: Cristina
authors.initials: C
authors.lastname: Caruso
authors.forename: Caterina
authors.initials: C
authors.lastname: Bressi
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Pressello
authors.forename: Maurizio
authors.initials: M
authors.lastname: Salvati
authors.forename: Alberto
authors.initials: A
authors.lastname: Delitala
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016019:Survival Analysis; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide