Hypofractionated high-dose irradiation for the treatment of malignant astrocytomas using simultaneous integrated boost technique by IMRT
Hypofractionated high-dose irradiation for the treatment of malignant astrocytomas using simultaneous integrated boost technique by IMRT
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DOI：
10.1016/j.ijrobp.2005.12.005
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发表时间：
2006-04-01
影响因子：
7
通讯作者：
Osato, K
中科院分区：
文献类型：
--
作者：
Iuchi, T;Hatano, K;Osato, K
目的：目的：探讨大分割高剂量同步增强调强放疗（IMRT）治疗恶性星形细胞瘤（MAs）的临床意义。方法：25例MAs患者接受IMRT治疗。三个分层的计划目标体积（PTVs）的轮廓。PTV-1是边缘为5 mm的强化病变区域; PTV-2是PTV-1周围边缘为15 mm的区域; PTV-3是病灶周围水肿区域。照射分8次进行，仅PTV-1的剂量从48戈伊递增至68戈伊，同时维持PTV-2（40戈伊）和PTV-3（32戈伊）的剂量。将IMRT的临床结局与60例常规外照射（EBI）治疗的MA患者进行比较。结果：IMRT组患者的无进展生存期明显长于EBI组（p < 0.0001）。两组均未观察到远端失效。在IMRT组中，播散是最常见的死亡原因（70%）。IMRT组患者的总生存率优于EBI组（p = 0.043）。结论：IMRT方案有助于控制局部和浸润性肿瘤，从而提高患者的生存率。(c)2006年爱思唯尔公司
Purpose: We evaluated the clinical significance of hypofractionated high-dose irradiation using simultaneous integrated boost technique with intensity-modulated radiation therapy (IMRT) for the treatment of malignant astrocytomas (MAs).Methods and Materials: Twenty-five patients with MAs were treated by IMRT. Three layered planning target volumes (PTVs) were contoured. PTV-1 was the area of enhanced lesion with 5-mm margin; PTV-2 was the area with 15-mm margin surrounding the PTV-1; PTV-3 was the area of perifocal edema. Irradiation was performed in 8 fractions, and only the dose for PTV-1 was escalated from 48 Gy to 68 Gy while maintaining the dose for PTV-2 (40 Gy) and PTV-3 (32 Gy). The clinical outcome of IMRT was compared with 60 MA patients treated by conventional external beam irradiation (EBI).Results: The progression-free survival of patients in the IMRT group was significantly longer than that in the EBI group (p < 0.0001). No distant failure was observed in both groups. In the IMRT group, dissemination was the most frequent cause of death (70%). The overall survival of patients in the IMRT group was better than that in the EBI group (p = 0.043).Conclusions: Our regimen of IMRT contributed to the control of both the regional and infiltrating tumors, resulting in better survival of patients. (c) 2006 Elsevier Inc.