3D-recurrence-patterns of glioblastomas after CT-planned postoperative irradiation
3D-recurrence-patterns of glioblastomas after CT-planned postoperative irradiation
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DOI：
10.1016/s0167-8140(99)00117-6
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发表时间：
1999-10-01
影响因子：
5.7
通讯作者：
Flentje, M
中科院分区：
文献类型：
--
作者：
Oppitz, U;Maessen, D;Flentje, M
背景和目的：引入计算机断层扫描作为颅内肿瘤照射的先进计划工具，导致了关于恶性胶质瘤初次和术后治疗的最佳靶体积的有争议的讨论。本研究分析了三维肿瘤再生长模式相对于治疗体积，其中包括宏观术前肿瘤和2厘米的安全margin.Materials和方法：79例经组织学证实的多形性胶质母细胞瘤和记录复发谁在我们的部门在1990年和1996年之间照射进行了审查。借助一个计算机程序的帮助下，基于CT的治疗计划的PTV重建和其空间轮廓与重建体积的复发肿瘤在控制CT study.Results：在33 34例CT研究显示肿瘤复发是可用的复发完全位于原来的90%-等剂量。只有一个肿瘤超过了PTV的外表面，但主要是位于原来的tumourbed内，并建议在高剂量volume.Conclusions肿瘤再生长：上述结果表明，目标体积的基础上，术前大小的增强肿瘤肿块覆盖几乎所有的情况下复发的网站。研究结果表明，剂量递增至更有限的体积。(C)1999爱思唯尔科学爱尔兰有限公司保留所有权利。
Background and purpose: The introduction of computed-tomography as an advanced planning tool for the irradiation of intracranial tumours led to a controversial discussions about the optimal target-volume for the primary and postoperative treatment of malignant gliomas. This study analyses the three-dimensional tumour regrowth pattern relative to the treated volume which included the macroscopic preoperative tumour and 2-cm safety margin.Materials and methods: Seventy-nine patients with histologically-confirmed Glioblastoma multiforma and documented recurrence who were irradiated in our department between 1990 and 1996 were reviewed. With the help of a computer program written for this purpose, the PTV of the CT-based treatment plan was reconstructed and its spatial outline compared with the reconstructed volume of the recurrent tumour in the control CT-study.Results: In 33 out 34 patients for which the CT-study showing tumour-recurrence was available the recurrence was completely situated within the original 90%-isodose. Only one tumour surpassed the outside surface of the PTV but was predominantly situated within the original tumourbed and suggests a tumour-regrowth within the high dose volume.Conclusions: The above results show that target-volumes based on the preoperative size of the enhanced tumour mass well cover the site of recurrence in nearly all cases. The findings suggest dose escalation to a more restricted volume. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.