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 language | English (US) |
|---|---|
| Article number | 26 |
| Journal | Radiation Oncology |
| Volume | 2 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 14 2007 |
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ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
- Medicine(all)
Cite this
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 journal › Article
}
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 -