Re-irradiation of recurrent glioblastoma multiforme using 11C-methionine PET/CT/MRI image fusion for hypofractionated stereotactic radiotherapy by intensity modulated radiation therapy

Radiation Oncology

Toru Iwama²  Hirohito Yano²  Jitsuhiro Yamada⁵  Kazutoshi Yokoyama⁵  Jun Shinoda³  Shin-ichi Ogawa¹  Masayuki Matsuo¹  Kazuhiro Miwa⁴ 

[1] Department of Radiation Oncology, Kizawa Memorial Hospital, Minokamo, Gifu, Japan;Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan;Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu, Japan;Department of Neurosurgery, Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, 630 Shimokobi, Kobi-cho, Minokamo, Gifu 505-0034, Japan;Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Gifu, Japan

关键词: ¹¹C-methionine PET;    Intensity modulated radiation therapy;    Hypofractionated stereotactic radiotherapy;    Recurrent glioblastoma multiforme;   

Others  :  1151798
DOI  :  10.1186/1748-717X-9-181

 received in 2014-04-23, accepted in 2014-08-12,  发布年份 2014

【 摘 要 】

Background

This research paper presents a valid treatment strategy for recurrent glioblastoma multiforme (GBM) using hypofractionated stereotactic radiotherapy by intensity modulated radiation therapy (HS-IMRT) planned with ¹¹C-methionine positron emission tomography (MET-PET)/computed tomography (CT)/magnetic resonance imaging (MRI) fusion.

Methods

Twenty-one patients with recurrent GBM received HS-IMRT planned by MET-PET/CT/MRI. The region of increased amino acid tracer uptake on MET-PET was defined as the gross tumor volume (GTV). The planning target volume encompassed the GTV by a 3-mm margin. Treatment was performed with a total dose of 25- to 35-Gy, given as 5- to 7-Gy daily for 5 days.

Results

With a median follow-up of 12 months, median overall survival time (OS) was 11 months from the start of HS-IMRT, with a 6-month and 1-year survival rate of 71.4% and 38.1%, respectively. Karnofsky performance status was a significant prognostic factor of OS as tested by univariate and multivariate analysis. Re-operation rate was 4.8% for radiation necrosis. No other acute or late toxicity Grade 3 or higher was observed.

Conclusions

This is the first prospective study of biologic imaging optimized HS-IMRT in recurrent GBM. HS-IMRT with PET data seems to be well tolerated and resulted in a median survival time of 11 months after HS-IMRT.

【 授权许可】

   
2014 Miwa et al.; licensee BioMed Central Ltd.

【 图 表 】

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