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Feasibility and Outcomes of Hypofractionated Simultaneous Integrated Boost-Intensity Modulated Radiotherapy for Malignant Gliomas: A Preliminary Report

 Jihye Cha  ;  Chang-Ok Suh  ;  Kwangwoo Park  ;  Jong Hee Chang  ;  Kyu Sung Lee  ;  Se Hoon Kim  ;  Jee Suk Chang  ;  Joo Ho Kim  ;  Yang-Gun Suh  ;  Jun Won Kim  ;  Jaeho Cho 
 YONSEI MEDICAL JOURNAL, Vol.55(1) : 70-77, 2014 
Journal Title
Issue Date
Adult ; Aged ; Female ; Glioma/radiotherapy* ; Humans ; Male ; Middle Aged ; Radiotherapy, Intensity-Modulated/methods* ; Retrospective Studies ; Young Adult
Radiotherapy ; hypofractionation ; intensity-modulated ; malignant glioma ; simultaneous integrated boost
PURPOSE: The aim of this study was to assess the feasibility and efficacy of hypofractionated simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) using three-layered planning target volumes (PTV) for malignant gliomas.
MATERIALS AND METHODS: We conducted a retrospective analysis of 12 patients (WHO grade IV-10; III-2) postoperatively treated with SIB-IMRT with concurrent temozolomide. Three-layered PTVs were contoured based on gadolinium-enhanced magnetic resonance imaging as follows; high risk PTV (H-PTV) as the area of surgical bed including residual gross tumor with a 0.5 cm margin; low risk PTV (L-PTV) as the area surrounding the high risk PTV with 1.5 cm margin; moderate risk PTV (M-PTV) as a line at one-third the distance from high risk PTV to low risk PTV. Total dose to high risk PTV was 70 Gy in 8 and 62.5 Gy in 4 patients.
RESULTS: The median follow-up time was 52 months in surviving patients. The 2- and 5-year overall survival (OS) rates were 66.6% and 47.6%, respectively. The 2- and 5-year progression-free survival (PFS) rates were 57.1% and 45.7%, respectively. The median OS and PFS were 48 and 31 months, respectively. Six patients (50%) progressed: in-field only in one, out-field or disseminated in 4, and both in one patient. All patients completed planned treatments without a toxicity-related gap. Asymptomatic radiation necrosis was observed in 4 patients at post-radiotherapy 9-31 months.
CONCLUSION: An escalated dose of hypofractionated SIB-IMRT using three-layered PTVs can be safely performed in patients with malignant glioma, and might contribute to better tumor control and survival.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Park, Kwang Woo(박광우) ORCID logo https://orcid.org/0000-0002-9843-7985
Suh, Yang Gun(서양권)
Suh, Chang Ok(서창옥)
Lee, Kyu Sung(이규성)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
Cha, Ji Hye(차지혜)
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