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| Clinical Research of Simultaneous Integrated Boost Intensity-Modulated Radiotherapy Combined with Temozolomide in Treatment of Postoperativeresidual Glioblastoma |
| REN Ai-jun1, SHAO Qian2, LU Jie3, LI Feng-xiang2, LI Jian-bin2 |
| Department of Radiation Oncology, Shandong Tumor Hospital, Jinan 250117 China |
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Abstract Objective To study the clinical efficacy of simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT) combined with temozolomide in treatment of patients with postoperativeresidual glioblastoma. Methods Fifty six patients with postoperativeresidual glioblastomaof brain received SIB-IMRT. The postoperative residual lesion was defined as gross tumor volume(GTV). The margin of GTV expanded 5 mm was defined as CTV. The margin of CTV expanded 5 mm was defined as PTV. The postoperative resectional cavity was defined as CTV1. The margins of CTV1 which were enlarged 15 mm and 30 mm were defined as PTV1 and PTV2 respectively. Doses of 2.5 Gy/f, 2.3Gy/f and 2.0 Gy/f were prescribed for PTV, PTV1 and PTV2 respectively. All patients received irradiation for 5 weeks 5 times per week. All patients were given temozolomide 75 mg/m2 oral daily during radiotherapy. Four weeks after radiotherapy there were 26 patients (defined as group A) did not continue to take temozolomide. The other 30 patients (defined as group B) received 6 cycles of temozolomide,each cycle lasted 5 days with 28 days interval between two cycles. Results In the 56 patients,CR was 7 cases(12.5%),PR was 38 cases(67.8%),SD was 8 cases(14.3%),PD was 3 cases (5.4%). The responed cases were 45 (80.3%). The median survival time in all patients, group A and group B was 30 months,23 months and 36 months respectively. The mean survival time was (29.82 ±9.11) months in all patients. The overall survival rates of one-,two-and three-year were 96.4%, 73.2%,and 33.9% respectively. The mean survival time and survival curve in group A were significantly lower than that in group B(P < 0.05). There were no severe radiochemotherapy-related toxicities. Conclusion Concurrent SIB-IMRT with temozolomide and followed by 6 cycles of temozolomide chemotherapy for postoperativeresidual glioblastoma has a better clinicaloutcome, good tolerance and no severe radiochemotherapy-related toxicities.
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Received: 01 May 2013
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