title: Hypofractionated high-dose irradiation with positron emission tomography data for the treatment of glioblastoma multiforme.
abstract: This research paper presents clinical outcomes of hypofractionated high-dose irradiation by intensity-modulated radiation therapy (Hypo-IMRT) with (11)C-methionine positron emission tomography (MET-PET) data for the treatment of glioblastoma multiforme (GBM). A total of 45 patients with GBM were treated with Hypo-IMRT after surgery. Gross tumor volume (GTV) was defined as the area of enhanced lesion on MRI, including MET-PET avid region; clinical target volume (CTV) was the area with 5 mm margin surrounding the GTV; planning target volume (PTV) was the area with 15 mm margin surrounding the CTV, including MET-PET moderate region. Hypo-IMRT was performed in 8 fractions; planning the dose for GTV was escalated to 68 Gy and that for CTV was escalated to 56 Gy, while keeping the dose delivered to the PTV at 40 Gy. Concomitant and adjuvant TMZ chemotherapy was administered. At a median follow-up of 18.7 months, median overall survival (OS) was 20.0 months, and median progression-free survival was 13.0 months. The 1- and 2-year OS rates were 71.2% and 26.3%, respectively. Adjuvant TMZ chemotherapy was significantly predictive of OS on multivariate analysis. Late toxicity included 7 cases of Grade 3-4 radiation necrosis. Hypo-IMRT with MET-PET data appeared to result in favorable survival outcomes for patients with GBM.
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu 505-0034, Japan ; Department of Neurosurgery, Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, 630 Shimokobi, Kobi-cho, Minokamo, Gifu 505-0034, Japan.
authors: Kazuhiro
authors: K
authors: Miwa
authors: Department of Radiation Oncology, Kizawa Memorial Hospital, Minokamo, Gifu 505-0034, Japan.
authors: Masayuki
authors: M
authors: Matsuo
authors: Department of Radiation Oncology, Kizawa Memorial Hospital, Minokamo, Gifu 505-0034, Japan.
authors: Shin-ichi
authors: S
authors: Ogawa
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu 505-0034, Japan.
authors: Jun
authors: 0000-0002-8106-4588
authors: J
authors: Shinoda
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu 505-0034, Japan.
authors: Yoshitaka
authors: Y
authors: Asano
authors: Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Gifu 505-0034, Japan.
authors: Takeshi
authors: 0000-0003-2236-9282
authors: T
authors: Ito
authors: Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Gifu 505-0034, Japan.
authors: Kazutoshi
authors: K
authors: Yokoyama
authors: Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Gifu 505-0034, Japan.
authors: Jitsuhiro
authors: J
authors: Yamada
authors: Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu 501-1193, Japan.
authors: Hirohito
authors: 0000-0002-4252-4780
authors: H
authors: Yano
authors: Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu 501-1193, Japan.
authors: Toru
authors: T
authors: Iwama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018450:Disease Progression; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009336:Necrosis; D049268:Positron-Emission Tomography; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents