title: Radiotherapy using IMRT boosts after hyperbaric oxygen therapy with chemotherapy for glioblastoma.
abstract: The purpose of this study was to evaluate the feasibility and efficacy of radiotherapy (RT) using intensity-modulated radiotherapy (IMRT) boosts after hyperbaric oxygen (HBO) therapy with chemotherapy in patients with glioblastoma. Twenty-four patients with glioblastoma were treated with the combined therapy, which was RT using IMRT boosts after HBO with chemotherapy, and were retrospectively analyzed. The RT protocol was as follows: first, 3D conformal RT [40 Gy/20 fractions (fr)] was delivered to the gross tumor volume (GTV) and the surrounding edema, including an additional 1.5-2.0 cm. The IMRT boost doses were then continuously delivered to the GTV plus 5 mm (28 Gy/8 fr) and the surrounding edema (16 Gy/8 fr). Each IMRT boost session was performed immediately after HBO to achieve radiosensitization. The planned RT dose was completed in all patients, while HBO therapy was terminated in one patient (4%) due to Grade 2 aural pain. The toxicities were mild, no non-hematological toxicity of Grade 3-5 was observed. The 2-year overall survival (OS) and progression-free survival rates in all patients were 46.5% and 35.4%, respectively. The median OS time was 22.1 months. In conclusion, the combined therapy of RT using IMRT boosts after HBO with chemotherapy was a feasible and promising treatment modality for patients with glioblastoma. The results justify further evaluation to clarify the benefits of this therapy.
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Yahara
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohguri
authors.affiliation: Department of Neurosurgery, Tobata Kyoritsu Hospital, Kitakyushu, Japan, University of Occupational and Environmental Health, 2-5-1 Sawami Tobata-ku, Kitakyushu 804-0093, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Udono
authors.affiliation: Department of Neurosurgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Junkoh
authors.initials: J
authors.lastname: Yamamoto
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Tomura
authors.affiliation: Department of Cancer Therapy Center, Tobata Kyoritsu Hospital, Kitakyushu, Japan, University of Occupational and Environmental Health, 2-5-1 Sawami Tobata-ku, Kitakyushu 804-0093, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Onoda
authors.affiliation: Department of Cancer Therapy Center, Tobata Kyoritsu Hospital, Kitakyushu, Japan, University of Occupational and Environmental Health, 2-5-1 Sawami Tobata-ku, Kitakyushu 804-0093, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Imada
authors.affiliation: Department of Neurosurgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nishizawa
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Yukunori
authors.initials: Y
authors.lastname: Korogi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000628:therapy*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D050397:Radiotherapy, Intensity-Modulated; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: glioblastoma; high-grade glioma; hyperbaric oxygen; intensity-modulated radiotherapy; radiosensitization