The Helical Tomotherapy Experience on Radiotherapy of Glioblastoma Multiforme

Abstract

Objective: The standard treatment of Glioblastome Multiforme (GBM) is surgical resection followed by chemoradiotherapy and adjuvant temozolamide. Intensity Modulated Radiotherapy (IMRT) offer an advantage in terms of reducing the dose to critical normal structures and a reduced dose to the normal brain. It also offers application of Simultaneous Integrated Boost (SIB). Material and Methods:Among our 12 patients, 7 had a diagnosis of GBM whereas 3 of them were anaplastic oligoastrocytoma and 2 of them were diagnosed radiologically as high-grade glial tumor. In all patients, 60 Gy SIB-IMRT with concomitant Temozolomide was used. Results:In post treatment Magnetic Resonance Imaging (MRI), 8 patients had no recurrence whereas 2 patients showed partial response and in 2 patients there was no response at all. After a median follow-up period of 12 months, 3 patients survived disease free, and 9 patients were expired. The overall survival was 14.8 months. Median progression free survival was 4.4 months. The mean dose received by the brain stem was 12.90 Gy and 12.72 Gy for the optic chiasm. Conclusion:High doses can be given while protecting critical tissues with SIB-IMRT.