Toxicity and efficacy of re-irradiation of high-grade glioma in a phase I dose- and volume escalation trial
(2017) In Radiotherapy and Oncology 125(2). p.223-227- Abstract
Introduction The purpose of this study was to evaluate the safety and efficacy of PET and MRI guided re-irradiation of recurrent high-grade glioma (HGG) and to assess the impact of radiotherapy dose, fractionation and irradiated volume. Material and methods Patients with localized, recurrent HGG (grades III-IV) and no other treatment options were eligible for a prospective phase I trial. Gross tumor volumes for radiotherapy were defined using T1-contrast enhanced MRI and 18F-fluoro-ethyl tyrosine PET. Radiotherapy was delivered using volumetric modulated arc therapy with a 2-mm margin. The dose prescription of four consecutive groups was (1) 35 Gy/10fr., (2) 42 Gy/10fr., (3) 29.5 Gy/5fr. and (4) 35 Gy/10fr. to larger tumor... (More)
Introduction The purpose of this study was to evaluate the safety and efficacy of PET and MRI guided re-irradiation of recurrent high-grade glioma (HGG) and to assess the impact of radiotherapy dose, fractionation and irradiated volume. Material and methods Patients with localized, recurrent HGG (grades III-IV) and no other treatment options were eligible for a prospective phase I trial. Gross tumor volumes for radiotherapy were defined using T1-contrast enhanced MRI and 18F-fluoro-ethyl tyrosine PET. Radiotherapy was delivered using volumetric modulated arc therapy with a 2-mm margin. The dose prescription of four consecutive groups was (1) 35 Gy/10fr., (2) 42 Gy/10fr., (3) 29.5 Gy/5fr. and (4) 35 Gy/10fr. to larger tumor volumes (100–300 cm3), respectively. Results Thirty-one patients were treated of which 81% had glioblastoma. The median progression-free survival was 2.8 months (95%CI: 2.1–3.5) and the median overall survival was 7.0 months (95%CI: 3.5–10.5). Early side effects were mild and included headache and fatigue. Seven patients were progression-free beyond 10 weeks and were evaluable for late toxicity. Among these patients, three (43%) suffered late adverse events which included radionecrosis and irreversible white matter changes. Conclusion Re-irradiation showed limited efficacy and 43% of patients achieving disease control suffered late toxicity that was manageable but not negligible.
(Less)
- author
- Møller, Søren ; Munck af Rosenschöld, Per LU ; Costa, Junia ; Law, Ian ; Poulsen, Hans Skovgaard ; Engelholm, Svend Aage and Engelholm, Silke
- publishing date
- 2017-11-01
- type
- Contribution to journal
- publication status
- published
- keywords
- High-grade glioma, phase I trial, Re-irradiation
- in
- Radiotherapy and Oncology
- volume
- 125
- issue
- 2
- pages
- 5 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:29054380
- scopus:85031744921
- ISSN
- 0167-8140
- DOI
- 10.1016/j.radonc.2017.09.039
- language
- English
- LU publication?
- no
- id
- e6fba930-71a2-4337-b828-39c51b23f5c6
- date added to LUP
- 2020-07-28 08:45:39
- date last changed
- 2024-09-19 04:37:16
@article{e6fba930-71a2-4337-b828-39c51b23f5c6, abstract = {{<p>Introduction The purpose of this study was to evaluate the safety and efficacy of PET and MRI guided re-irradiation of recurrent high-grade glioma (HGG) and to assess the impact of radiotherapy dose, fractionation and irradiated volume. Material and methods Patients with localized, recurrent HGG (grades III-IV) and no other treatment options were eligible for a prospective phase I trial. Gross tumor volumes for radiotherapy were defined using T1-contrast enhanced MRI and <sup>18</sup>F-fluoro-ethyl tyrosine PET. Radiotherapy was delivered using volumetric modulated arc therapy with a 2-mm margin. The dose prescription of four consecutive groups was (1) 35 Gy/10fr., (2) 42 Gy/10fr., (3) 29.5 Gy/5fr. and (4) 35 Gy/10fr. to larger tumor volumes (100–300 cm<sup>3</sup>), respectively. Results Thirty-one patients were treated of which 81% had glioblastoma. The median progression-free survival was 2.8 months (95%CI: 2.1–3.5) and the median overall survival was 7.0 months (95%CI: 3.5–10.5). Early side effects were mild and included headache and fatigue. Seven patients were progression-free beyond 10 weeks and were evaluable for late toxicity. Among these patients, three (43%) suffered late adverse events which included radionecrosis and irreversible white matter changes. Conclusion Re-irradiation showed limited efficacy and 43% of patients achieving disease control suffered late toxicity that was manageable but not negligible.</p>}}, author = {{Møller, Søren and Munck af Rosenschöld, Per and Costa, Junia and Law, Ian and Poulsen, Hans Skovgaard and Engelholm, Svend Aage and Engelholm, Silke}}, issn = {{0167-8140}}, keywords = {{High-grade glioma; phase I trial; Re-irradiation}}, language = {{eng}}, month = {{11}}, number = {{2}}, pages = {{223--227}}, publisher = {{Elsevier}}, series = {{Radiotherapy and Oncology}}, title = {{Toxicity and efficacy of re-irradiation of high-grade glioma in a phase I dose- and volume escalation trial}}, url = {{http://dx.doi.org/10.1016/j.radonc.2017.09.039}}, doi = {{10.1016/j.radonc.2017.09.039}}, volume = {{125}}, year = {{2017}}, }