Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme

Clifton D. Fuller, Mehee Choi, Britta Forthuber, Samuel Wang, Nancy Rajagiriyil, Bill J. Salter, Martin Fuss

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: Intensity-modulated radiation therapy (IMRT) affords unparalleled capacity to deliver conformal radiation doses to tumors in the central nervous system. However, to date, there are few reported outcomes from using IMRT, either alone or as a boost technique, for standard fractionation radiotherapy for glioblastoma multiforme (GBM). Methods: Forty-two patients were treated with IMRT alone (72%) or as a boost (28%) after 3-dimensional conformal radiation therapy (3D-CRT). Thirty-three patients with primary disease and 9 patients with recurrent tumors were included. Thirty-four patients (81%) had surgery, with gross tumor resection in 13 patients (36%); 22 patients (53%) received chemo-radiotherapy. The median total radiation dose for all patients was 60 Gy with a range from 30.6 to 74 Gy. Standard fractions of 1.8 Gy/day to 2.0 Gy/day were utilized. Results: Median survival was 8.7 months, with 37 patients (88%) deceased at last contact. Nonparametric analysis showed no survival difference in IMRT-boost vs. IMRT-only groups. Conclusion: While technically feasible, preliminary results suggest delivering standard radiation doses by IMRT did not improve survival outcomes in this series compared to historical controls. In light of this lack of a survival benefit and the costs associated with use of IMRT, future prospective trials are needed to evaluate non-survival endpoints such as quality of life and functional preservation. Short of such evidence, the use of IMRT for treatment of GBM needs to be carefully rationalized.

Original languageEnglish (US)
Article number26
JournalRadiation Oncology
Volume2
Issue number1
DOIs
StatePublished - Jul 14 2007

Fingerprint

Glioblastoma
Radiotherapy
Survival
Radiation
Central Nervous System Neoplasms
Cost-Benefit Analysis
Neoplasms
Quality of Life

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Fuller, C. D., Choi, M., Forthuber, B., Wang, S., Rajagiriyil, N., Salter, B. J., & Fuss, M. (2007). Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme. Radiation Oncology, 2(1), [26]. https://doi.org/10.1186/1748-717X-2-26

Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme. / Fuller, Clifton D.; Choi, Mehee; Forthuber, Britta; Wang, Samuel; Rajagiriyil, Nancy; Salter, Bill J.; Fuss, Martin.

In: Radiation Oncology, Vol. 2, No. 1, 26, 14.07.2007.

Research output: Contribution to journalArticle

Fuller, Clifton D. ; Choi, Mehee ; Forthuber, Britta ; Wang, Samuel ; Rajagiriyil, Nancy ; Salter, Bill J. ; Fuss, Martin. / Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme. In: Radiation Oncology. 2007 ; Vol. 2, No. 1.
@article{23c58e3649f5435cbc3d1d2ad7ffc955,
title = "Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme",
abstract = "Background: Intensity-modulated radiation therapy (IMRT) affords unparalleled capacity to deliver conformal radiation doses to tumors in the central nervous system. However, to date, there are few reported outcomes from using IMRT, either alone or as a boost technique, for standard fractionation radiotherapy for glioblastoma multiforme (GBM). Methods: Forty-two patients were treated with IMRT alone (72{\%}) or as a boost (28{\%}) after 3-dimensional conformal radiation therapy (3D-CRT). Thirty-three patients with primary disease and 9 patients with recurrent tumors were included. Thirty-four patients (81{\%}) had surgery, with gross tumor resection in 13 patients (36{\%}); 22 patients (53{\%}) received chemo-radiotherapy. The median total radiation dose for all patients was 60 Gy with a range from 30.6 to 74 Gy. Standard fractions of 1.8 Gy/day to 2.0 Gy/day were utilized. Results: Median survival was 8.7 months, with 37 patients (88{\%}) deceased at last contact. Nonparametric analysis showed no survival difference in IMRT-boost vs. IMRT-only groups. Conclusion: While technically feasible, preliminary results suggest delivering standard radiation doses by IMRT did not improve survival outcomes in this series compared to historical controls. In light of this lack of a survival benefit and the costs associated with use of IMRT, future prospective trials are needed to evaluate non-survival endpoints such as quality of life and functional preservation. Short of such evidence, the use of IMRT for treatment of GBM needs to be carefully rationalized.",
author = "Fuller, {Clifton D.} and Mehee Choi and Britta Forthuber and Samuel Wang and Nancy Rajagiriyil and Salter, {Bill J.} and Martin Fuss",
year = "2007",
month = "7",
day = "14",
doi = "10.1186/1748-717X-2-26",
language = "English (US)",
volume = "2",
journal = "Radiation Oncology",
issn = "1748-717X",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme

AU - Fuller, Clifton D.

AU - Choi, Mehee

AU - Forthuber, Britta

AU - Wang, Samuel

AU - Rajagiriyil, Nancy

AU - Salter, Bill J.

AU - Fuss, Martin

PY - 2007/7/14

Y1 - 2007/7/14

N2 - Background: Intensity-modulated radiation therapy (IMRT) affords unparalleled capacity to deliver conformal radiation doses to tumors in the central nervous system. However, to date, there are few reported outcomes from using IMRT, either alone or as a boost technique, for standard fractionation radiotherapy for glioblastoma multiforme (GBM). Methods: Forty-two patients were treated with IMRT alone (72%) or as a boost (28%) after 3-dimensional conformal radiation therapy (3D-CRT). Thirty-three patients with primary disease and 9 patients with recurrent tumors were included. Thirty-four patients (81%) had surgery, with gross tumor resection in 13 patients (36%); 22 patients (53%) received chemo-radiotherapy. The median total radiation dose for all patients was 60 Gy with a range from 30.6 to 74 Gy. Standard fractions of 1.8 Gy/day to 2.0 Gy/day were utilized. Results: Median survival was 8.7 months, with 37 patients (88%) deceased at last contact. Nonparametric analysis showed no survival difference in IMRT-boost vs. IMRT-only groups. Conclusion: While technically feasible, preliminary results suggest delivering standard radiation doses by IMRT did not improve survival outcomes in this series compared to historical controls. In light of this lack of a survival benefit and the costs associated with use of IMRT, future prospective trials are needed to evaluate non-survival endpoints such as quality of life and functional preservation. Short of such evidence, the use of IMRT for treatment of GBM needs to be carefully rationalized.

AB - Background: Intensity-modulated radiation therapy (IMRT) affords unparalleled capacity to deliver conformal radiation doses to tumors in the central nervous system. However, to date, there are few reported outcomes from using IMRT, either alone or as a boost technique, for standard fractionation radiotherapy for glioblastoma multiforme (GBM). Methods: Forty-two patients were treated with IMRT alone (72%) or as a boost (28%) after 3-dimensional conformal radiation therapy (3D-CRT). Thirty-three patients with primary disease and 9 patients with recurrent tumors were included. Thirty-four patients (81%) had surgery, with gross tumor resection in 13 patients (36%); 22 patients (53%) received chemo-radiotherapy. The median total radiation dose for all patients was 60 Gy with a range from 30.6 to 74 Gy. Standard fractions of 1.8 Gy/day to 2.0 Gy/day were utilized. Results: Median survival was 8.7 months, with 37 patients (88%) deceased at last contact. Nonparametric analysis showed no survival difference in IMRT-boost vs. IMRT-only groups. Conclusion: While technically feasible, preliminary results suggest delivering standard radiation doses by IMRT did not improve survival outcomes in this series compared to historical controls. In light of this lack of a survival benefit and the costs associated with use of IMRT, future prospective trials are needed to evaluate non-survival endpoints such as quality of life and functional preservation. Short of such evidence, the use of IMRT for treatment of GBM needs to be carefully rationalized.

UR - http://www.scopus.com/inward/record.url?scp=34547799208&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547799208&partnerID=8YFLogxK

U2 - 10.1186/1748-717X-2-26

DO - 10.1186/1748-717X-2-26

M3 - Article

C2 - 17629934

AN - SCOPUS:34547799208

VL - 2

JO - Radiation Oncology

JF - Radiation Oncology

SN - 1748-717X

IS - 1

M1 - 26

ER -