Simultaneous integrated boost intensity-modulated radiotherapy in patients with high-grade gliomas

Kwan Ho Cho, Joo Young Kim, Seung Hoon Lee, Heon Yoo, Sang Hoon Shin, Sung Ho Moon, Tae Hyun Kim, Kyung Hwan Shin, Myonggeun Yoon, Doo Hyun Lee, Hong Ryull Pyo

Research output: Contribution to journalArticle

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Abstract

Purpose: We analyzed outcomes of simultaneous integrated boost (SIB) intensity-modulated radiotherapy (IMRT) in patients with high-grade gliomas, compared with a literature review. Methods and Materials: Forty consecutive patients (WHO grade III, 14 patients; grade IV, 26 patients) treated with SIB-IMRT were analyzed. A dose of 2.0 Gy was delivered to the planning target volume with a SIB of 0.4 Gy to the gross tumor volume with a total dose of 60 Gy to the gross tumor volume and 50 Gy to the planning target volume in 25 fractions during 5 weeks. Twenty patients received temozolomide chemotherapy. Results: At a median follow-up of 13.4 months (range, 3.7-55.9 months), median survival was 14.8 months. One- and 2-year survival rates were 78% and 65%, respectively, for patients with grade III tumors and 56% and 31%, respectively, for patients with grade IV tumors. Age (≤50 vs. >50), grade (III vs. IV), subtype (astrocytoma vs. oligodendroglioma or mixed), and a Zubrod performance score (0-1 vs. >2) were predictive of survival. Of 25 (63%) patients who had recurrences, 17 patients had local failure, 9 patients had regional failure, and 1 patient had distant metastasis. Toxicities were acceptable. Conclusions: SIB-IMRT with the dose/fractionation used in this study is feasible and safe, with a survival outcome similar to the historical control. The shortening of treatment time by using SIB-IMRT may be of value, although further investigation is warranted to prove its survival advantage.

Original languageEnglish
Pages (from-to)390-397
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume78
Issue number2
DOIs
Publication statusPublished - 2010 Oct 1
Externally publishedYes

Fingerprint

Intensity-Modulated Radiotherapy
acceleration (physics)
Glioma
radiation therapy
grade
tumors
Survival
temozolomide
Tumor Burden
dosage
planning
Dose Fractionation
Oligodendroglioma
Astrocytoma
metastasis
chemotherapy
fractionation
toxicity
Neoplasms
Survival Rate

Keywords

  • Glioma
  • Intensity-modulated radiotherapy
  • Patterns of failure
  • Simultaneous integrated boost
  • Survival
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Simultaneous integrated boost intensity-modulated radiotherapy in patients with high-grade gliomas. / Cho, Kwan Ho; Kim, Joo Young; Lee, Seung Hoon; Yoo, Heon; Shin, Sang Hoon; Moon, Sung Ho; Kim, Tae Hyun; Shin, Kyung Hwan; Yoon, Myonggeun; Lee, Doo Hyun; Pyo, Hong Ryull.

In: International Journal of Radiation Oncology Biology Physics, Vol. 78, No. 2, 01.10.2010, p. 390-397.

Research output: Contribution to journalArticle

Cho, Kwan Ho ; Kim, Joo Young ; Lee, Seung Hoon ; Yoo, Heon ; Shin, Sang Hoon ; Moon, Sung Ho ; Kim, Tae Hyun ; Shin, Kyung Hwan ; Yoon, Myonggeun ; Lee, Doo Hyun ; Pyo, Hong Ryull. / Simultaneous integrated boost intensity-modulated radiotherapy in patients with high-grade gliomas. In: International Journal of Radiation Oncology Biology Physics. 2010 ; Vol. 78, No. 2. pp. 390-397.
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AU - Kim, Joo Young

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AU - Yoo, Heon

AU - Shin, Sang Hoon

AU - Moon, Sung Ho

AU - Kim, Tae Hyun

AU - Shin, Kyung Hwan

AU - Yoon, Myonggeun

AU - Lee, Doo Hyun

AU - Pyo, Hong Ryull

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N2 - Purpose: We analyzed outcomes of simultaneous integrated boost (SIB) intensity-modulated radiotherapy (IMRT) in patients with high-grade gliomas, compared with a literature review. Methods and Materials: Forty consecutive patients (WHO grade III, 14 patients; grade IV, 26 patients) treated with SIB-IMRT were analyzed. A dose of 2.0 Gy was delivered to the planning target volume with a SIB of 0.4 Gy to the gross tumor volume with a total dose of 60 Gy to the gross tumor volume and 50 Gy to the planning target volume in 25 fractions during 5 weeks. Twenty patients received temozolomide chemotherapy. Results: At a median follow-up of 13.4 months (range, 3.7-55.9 months), median survival was 14.8 months. One- and 2-year survival rates were 78% and 65%, respectively, for patients with grade III tumors and 56% and 31%, respectively, for patients with grade IV tumors. Age (≤50 vs. >50), grade (III vs. IV), subtype (astrocytoma vs. oligodendroglioma or mixed), and a Zubrod performance score (0-1 vs. >2) were predictive of survival. Of 25 (63%) patients who had recurrences, 17 patients had local failure, 9 patients had regional failure, and 1 patient had distant metastasis. Toxicities were acceptable. Conclusions: SIB-IMRT with the dose/fractionation used in this study is feasible and safe, with a survival outcome similar to the historical control. The shortening of treatment time by using SIB-IMRT may be of value, although further investigation is warranted to prove its survival advantage.

AB - Purpose: We analyzed outcomes of simultaneous integrated boost (SIB) intensity-modulated radiotherapy (IMRT) in patients with high-grade gliomas, compared with a literature review. Methods and Materials: Forty consecutive patients (WHO grade III, 14 patients; grade IV, 26 patients) treated with SIB-IMRT were analyzed. A dose of 2.0 Gy was delivered to the planning target volume with a SIB of 0.4 Gy to the gross tumor volume with a total dose of 60 Gy to the gross tumor volume and 50 Gy to the planning target volume in 25 fractions during 5 weeks. Twenty patients received temozolomide chemotherapy. Results: At a median follow-up of 13.4 months (range, 3.7-55.9 months), median survival was 14.8 months. One- and 2-year survival rates were 78% and 65%, respectively, for patients with grade III tumors and 56% and 31%, respectively, for patients with grade IV tumors. Age (≤50 vs. >50), grade (III vs. IV), subtype (astrocytoma vs. oligodendroglioma or mixed), and a Zubrod performance score (0-1 vs. >2) were predictive of survival. Of 25 (63%) patients who had recurrences, 17 patients had local failure, 9 patients had regional failure, and 1 patient had distant metastasis. Toxicities were acceptable. Conclusions: SIB-IMRT with the dose/fractionation used in this study is feasible and safe, with a survival outcome similar to the historical control. The shortening of treatment time by using SIB-IMRT may be of value, although further investigation is warranted to prove its survival advantage.

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KW - Intensity-modulated radiotherapy

KW - Patterns of failure

KW - Simultaneous integrated boost

KW - Survival

KW - Toxicity

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