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| Efficacy of postoperative radiotherapy with reduced target volume in patients with glioblastoma multiforme |
| LI Shouguo, GUO Qunhuang, GUO Ruixiang |
| Department of Tumor Radiotherapy, Zhongshan Hospital, Xiamen University, Xiamen 361004 China |
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Abstract Objective To evaluate the therapeutic efficacy of radiotherapy with reduced target volume in glioblastoma multiforme patients following surgical treatment, and to provide a basis for the development of postoperative radiotherapy regimens for glioblastoma multiforme. Methods The medical records of 29 patients with glioblastoma multiforme receiving postoperative adjuvant radiochemotherapy with a reduced radiation target were retrospectively reviewed. The gross tumor volume (GTV) included postoperative tumor cavity and residual lesions, and the clinical target volume (CTV) was GTV plus 2.5 cm margin with adaptation according to the affected organs and anatomic structures. GTV and CTV received intensity-modulated radiotherapy with concomitant boost at 60 Gy/30 fractions and 54 Gy/30 fractions, respectively. The progression-free survival (PFS) and site of recurrence were analyzed. Results The patients were followed up until March 2022. Among the 29 patients with glioblastoma multiforme, 3 showed recurrence-free survival of 52, 20, and 19 months, respectively. Among the 26 patients with recurrent glioblastoma multiforme, there were no case with recurrence in CTV, 25 cases with recurrence in GTV (including 3 cases with intracranial dissemination), and one case with intracranial dissemination and without recurrence in GTV. The median PFS was 7 months (4 to 15 months). Among the 3 patients with recurrence in GTV and intracranial dissemination, one showed primary lesion in the right frontal parietal lobe and the metastatic lesion in the right occipital lobe, one primary lesion in the right occipital lobe and multiple metastatic lesions in the cerebellum, and one primary lesion in the left frontal lobe and the metastatic lesion in the right frontal lobe. The PFS was 4 to 5 months for seven patients receiving partial resection, and 6 to 15 months for patients receiving total and subtotal resection. The three recurrence-free survivors all underwent total resection. Conclusion Recurrence in target volume still prevails in patients with glioblastoma multiforme receiving postoperative radiotherapy with reduced target volume, and 60 Gy/30 fractions fail to control the tumor cavity and residual lesions of glioblastoma multiforme.
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Received: 30 May 2022
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