Reirradiation of recurrent high-grade gliomas using amino acid PET (SPECT)/CT/MRI image fusion to determine gross tumor volume for stereotactic fractionated radiotherapy

Grosu, Anca L.; Weber, Wolfgang; Franz, M. A.; Stärk, S.; Piert, Morand; Thamm, Reinhard; Gumprecht, Hartmut; Schwaiger, Markus; Molls, M.; Nieder, Carsten

doi:10.1016/j.ijrobp.2005.01.056

Cited by 338 publications

(193 citation statements)

References 32 publications

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“…By using 11-C-methionine positron emission tomography for targeting, stereotactic fractionated radiotherapy was reported to have achieved the median survival time of 9 months. 30 Although the incidence of radiation necrosis after SRS was not significantly different between conventional and extended field SRS, all patients who developed radiation necrosis after extended field SRS required steroid administration. This risk of eventual necessity of steroid administration may be another limitation of this approach.…”

Section: Discussionmentioning

confidence: 84%

Extended field stereotactic radiosurgery for recurrent glioblastoma

Koga

Maruyama

Tanaka

et al. 2011

Cancer

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BACKGROUND: Stereotactic radiosurgery (SRS) is among the few therapeutic options for glioblastoma that recurs after standard radiation and chemotherapy, but its efficacy has been limited. METHODS: Since November 2007, the authors have modified the clinical target volume by adding a 0.5-to 1-cm margin to the gadolinium-enhanced area (extended field SRS), in contrast to conventional SRS using no margin to set the clinical target volume. A total of 35 recurred glioblastoma lesions in 9 patients were treated with conventional SRS between December 1990 and January 2007, and 14 lesions in 9 patients were treated with extended field SRS. RESULTS: The median follow-up periods were 7 months (range, 3-29 months) and 8 months (range, 6-27 months), respectively. The local control rate was 47% for conventional SRS and 93% for extended field SRS (P ¼ .0035), and the numbers of radiation necrosis observed in SRS-treated lesions were 2 and 4, respectively. The median overall survival from the diagnosis was 24 months (range, 14-57 months) for conventional SRS and 21 months (range, 15-51 months) for extended field SRS (statistically not significant). Seven patients treated with conventional SRS died during follow-up, 6 from progression of the SRS-treated tumor, whereas 7 patients treated with extended field SRS died during follow-up, 6 from remote intracerebral dissemination. CONCLUSIONS: Extended field SRS was superior to conventional SRS in the local control of small recurrent lesions of glioblastoma, although a further device to suppress remote dissemination may be necessary to increase survival. KEYWORDS: glioblastoma, glioma, gamma knife, stereotactic radiosurgery, radiation therapy, recurrence. INTRODUCTIONGlioblastoma is a highly malignant and aggressive tumor of the central nervous system that corresponds to grade IV of the World Health Organization histological classification. 1 The current standard treatment for glioblastoma is a maximal resection with functional preservation, followed by radiation and chemotherapy. When temozolomide is used for chemotherapy, the median survival is 14.6 months after initial presentation, 2 and ranges from 5 to 13 months after recurrence. 3,4 Because of the aggressive and invasive nature of the tumor, recurrence is seen in >90% of patients. 5 The most common pattern of recurrence is local regrowth 6 ; therefore, successful local control should lead to prolongation of patients' survival. Various local treatment strategies have been attempted, including repeated operations, conformal radiotherapy, brachytherapy, and local chemotherapy. 7 Although stereotactic radiosurgery (SRS) is an option as salvage treatment for recurrent glioblastoma in clinical settings, the role of SRS is still limited for glioma. SRS is useful in controlling relatively well-demarcated glioma such as ependymoma, pilocytic astrocytoma, and pleomorphic xanthoastrocytoma. [8][9][10][11][12][13] However, the majority of glioma is infiltrative to brain parenchyma and is difficult to target with SRS. A randomized controlle...

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Section: Discussionmentioning

confidence: 84%

Extended field stereotactic radiosurgery for recurrent glioblastoma

Koga

Maruyama

Tanaka

et al. 2011

Cancer

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“…As favorable variables for selecting patients likely to benefit from re-irradiation again general prognostic factors such as young age, high KPS or small tumor size have been proposed [32,[34][35][36][37]. Different reports exist regarding the preferred time interval to initial radiation for benefit from re-irradiation, favoring either an interval of less than 6 months [35] or more than 6 or even 12 months [37,38].…”

Section: Repeat Radiotherapymentioning

confidence: 99%

Therapeutic options in recurrent glioblastoma—An update

Seystahl

Wick

Weller

2016

Critical Reviews in Oncology/Hematology

177

134

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“…In a prospective phase-II-study about stereotactic re-irradiation of patients with relapse of malignant gliomas, biologic imaging (MET-PET or IMT-SPECT) was used for target volume definition in 36 patients. These patients showed a significantly longer median survival compared with the group of patients, in which target volume was merely defined by CT and MRI [14] .…”

Section: Met-and Fet-pet Have a Higher Exactness In The Differentiatimentioning

confidence: 74%