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- W2286748407 abstract "Standard treatment for recurrent glioblastoma (GBM) has not yet been established and many therapeutic modalities, alone or combined, are available. Re-irradiation may be a therapeutic option. We summarize our experience with hypofractionated stereotactic image- guided helical tomotherapy in recurrent GBM. Between August 2008 and February 2015, 21 patients underwent salvage therapy using hypofractionated stereotactic image-guided helical tomotherapy. The population comprised 9 females and 11 males with a median age of 55 years (range 21-70 years). All patients had grade IV glioma at the time of salvage therapy and a previous history of fractionated radiation therapy plus temozolomide. All radiation targeting volumes were delineated using fused CT and MRI scans. Two volumes of interest were defined, one of which was identified as the area of edema using T1, T2 and Flair sequences, while the second included the area of enhanced volume on the T1 sequence acquired after the injection of Gadolinium. The treated median tumor volumes were 121.2 cc (range 51.7-395 cc) and 45.7 cc (range 9.8-184 cc), respectively. Median total doses were 20-25 Gy in 5 fractions in the first area, and 25-30 Gy, with an inhomogeneously increasing dose up to 37.5 Gy in the second area (simulating brachytherapy). The median period of follow-up was 46. 5 months (CI 5.1-51.6). Median overall survival from re-irradiation was 10.7 months (SD 2.82; 95% CI 5.9-28.8). Six- and 12-month survival rates were 72.2% (95% CI 45.0-87.6) and 35% (95% CI 12.1-59.3), respectively. Our results suggest that hypofractionated stereotactic image-guided helical tomotherapy could be offered to patients with GBM who relapse after conventional treatment. The fractionation of the dose in multiple sessions (i.e. 5 fractions in 5 days) allows us to safety treat volumes larger than those treated by single-dose stereotactic radiosurgery." @default.
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- W2286748407 date "2015-11-01" @default.
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- W2286748407 title "Hypofractionated Stereotactic Image Guided Helical Tomotherapy for the Treatment of Recurrent Glioblastoma" @default.
- W2286748407 doi "https://doi.org/10.1016/j.ijrobp.2015.07.712" @default.
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