Efficacy of salvage stereotactic radiotherapy for recurrent glioma: impact of tumor morphology and method of target delineation on local control.
Efficacy of salvage stereotactic radiotherapy for recurrent glioma: impact of tumor morphology and method of target delineation on local control.
复制标题
DOI：
10.1002/cam4.154
复制
发表时间：
2013-12
期刊：
影响因子：
4
通讯作者：
Hiraoka, Masahiro
中科院分区：
文献类型：
--
作者：
Ogura, Kengo;Mizowaki, Takashi;Arakawa, Yoshiki;Sakanaka, Katsuyuki;Miyamoto, Susumu;Hiraoka, Masahiro
关键词：
在这项研究中，我们评估了挽救立体定向放射治疗(SRT)治疗复发性胶质瘤的疗效。自2008年8月至2012年12月，对30例复发的脑胶质瘤患者施行了补救SRT治疗。最初的组织学诊断分别为世界卫生组织(WHO)II、III和IV级6例、9例和15例。在形态上，复发类型被分为弥漫性或其他类型。临床靶点的勾画采用两种方法：A为对比度增强的肿瘤；或B为边缘3-10 mm和/或周围液体衰减反转恢复(FLAIR)高信号区的对比度增强的肿瘤。处方剂量为22.5-35Gy5次，采用动态适形弧形技术在等中心分5次照射。采用Kaplan-Meier法计算SRT后的总生存期(OS)和局部控制率(LCP)。采用单因素分析检验临床变量对OS/LCP的影响。SRT后的中位随访期为272天。术后6个月OS和LCP分别为83%和56%。在形态上，肿瘤类型与OS和LCP均显著相关(P分别为0.006和0.001)。靶点勾画方法对LCP也有显著影响(P=0.016)。根据3版不良事件通用术语标准，2例患者出现3级放射性坏死。对于复发性胶质瘤，尤其是非弥漫性复发，挽救SRT安全有效。通过增加增强对比剂肿瘤的边缘或包括增强的FLAIR高信号区，可获得改善的局部控制。
In this study, we assessed the efficacy of salvage stereotactic radiotherapy (SRT) for recurrent glioma. From August 2008 to December 2012, 30 patients with recurrent glioma underwent salvage SRT. The initial histological diagnoses were World Health Organization (WHO) grades II, III, and IV in 6, 9, and 15 patients, respectively. Morphologically, the type of recurrence was classified as diffuse or other. Two methods of clinical target delineation were used: A, a contrast-enhancing tumor; or B, a contrast-enhancing tumor with a 3–10-mm margin and/or surrounding fluid attenuation inversion recovery (FLAIR) high-intensity areas. The prescribed dose was 22.5–35 Gy delivered in five fractions at an isocenter using a dynamic conformal arc technique. The overall survival (OS) and local control probability (LCP) after SRT were calculated using the Kaplan–Meier method. A univariate analysis was used to test the effect of clinical variables on OS/LCP. The median follow-up period was 272 days after SRT. The OS and LCP were 83% and 56% at 6 months after SRT, respectively. Morphologically, the tumor type correlated significantly with both OS and LCP (P = 0.006 and <0.001, respectively). The method of target delineation also had a significant influence on LCP (P = 0.016). Grade 3 radiation necrosis was observed in two patients according to Common Terminology Criteria for Adverse Events, version 3. Salvage SRT was safe and effective for recurrent glioma, especially non-diffuse recurrences. Improved local control might be obtained by adding a margin to contrast-enhancing tumors or including increased FLAIR high-intensity areas.
登录
查看更多内容
对医疗统计信息的自由使用的易于使用的软件“ EZR”的调查。
影响因子：
4.8
作者：
Kanda Y
通讯作者：
Kanda Y
影响因子：
3.9
作者：
Hundsberger, Thomas;Bruegge, Detlef;Plasswilm, Ludwig
通讯作者：
Plasswilm, Ludwig
影响因子：
--
作者：
Maranzano, Ernesto;Anselmo, Paola;Giorgi, Cesare
通讯作者：
Giorgi, Cesare
DOI：
10.1016/j.ijrobp.2010.09.002
发表时间：
2012-01-01
影响因子：
7
作者：
Niyazi, Maximilian;Ganswindt, Ute;Belka, Claus
通讯作者：
Belka, Claus
影响因子：
3.9
作者：
Patel, Mehul;Siddiqui, Farzan;Ryu, Samuel
通讯作者：
Ryu, Samuel