Proton beam therapy with concurrent chemotherapy for glioblastoma multiforme: comparison of nimustine hydrochloride and temozolomide
|
|
- Barry McCoy
- 5 years ago
- Views:
Transcription
1 J Neurooncol DOI 1.17/s CLINIcAL STUDY Proton beam therapy with concurrent chemotherapy for glioblastoma multiforme: comparison of nimustine hydrochloride and temozolomide Masashi Mizumoto 1 Tetsuya Yamamoto 2 Eiichi Ishikawa 2 Masahide Matsuda 2 Shingo Takano 2 Hitoshi Ishikawa 1 Toshiyuki Okumura 1 Hideyuki Sakurai 1 Akira Matsumura 2 Koji Tsuboi 1 Received: 18 December 215 / Accepted: 28 July 21 Springer Science+Business Media New York 21 Abstract To evaluate the safety and efficacy of postoperative proton beam therapy (PBT) combined with nimustine hydrochloride (ACNU) or temozolomide (TMZ) for glio - blastoma multiforme (GBM). The subjects were 4 patients with GBM who were treated with high dose (9. GyE) PBT. There were 24 males and 22 females, and the median age was 58 years old (range 24 7). The Karnofsky perfor - mance status was, 7, 8, 9 and 1 in 5, 1, 12, 11 and 8 patients, respectively. Total resection, partial resec - tion, and biopsy were performed for 31, 14 and 1 patients, respectively. Photon beams were delivered to high intensity areas on T2-weighted magnetic resonance imaging (MRI) in the morning (5.4 Gy in 28 fractions). More than h later, PBT was delivered to the enhanced area plus a 1 mm margin in the first half of the protocol (23.1 GyE in 14 fractions) and to the enhanced volume in the second half (23.1 GyE in 14 fraction). Concurrent chemotherapy with ACNU during weeks 1 and 4 or daily TMZ was administered in 23 and 23 patients, respectively. The overall 1 and 2 year survival rates were 82. and 47. %, respectively. Median survival was 21.1 months (95 % CI ), with no significant difference in survival between the ACNU and TMZ groups. The patient characteristics were similar in the two groups. Late radiation necrosis occurred in 11 patients (six ACNU, five TMZ), but was controlled by necrotomy Koji Tsuboi tsuboi@pmrc.tsukuba.ac.jp 1 Department of Radiation Oncology, Proton Medical Research Center, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki , Japan 2 Department of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki, Japan and therapy including bevacizumab. PBT concurrent with ACNU or TMZ was tolerable and beneficial for carefully selected patients with GBM. Keywords Proton beam therapy Glioblastoma GBM TMZ Temozolomide Radiotherapy Introduction Glioblastoma multiforme (GBM) has a poor prognosis and the most aggressive therapies have achieved only mod - est outcomes. Radiotherapy after surgical resection may improve survival and time to progression [ 1 3] and radio - therapy plus chemotherapy produces a modest improvement in survival [ 4, 5]. Radiotherapy of Gy in 3 fractions plus temozolomide (TMZ) increased median survival in a phase III randomized trial compared to external beam radiotherapy alone [ 8], and recent reports have shown that bevacizumab plus radiotherapy and TMZ improve progression-free survival [ 9, 1]. Combined therapy with surgery, radiotherapy and chemotherapy extends the median survival time by about 1 months. Dose escalation has also been tried for GBM using new techniques such as intensity modulated radiation therapy (IMRT) or particle therapy. Tanaka et al. found that highdose conformal radiotherapy of 9 Gy in 45 fractions for malignant glioma had potential to improve survival [ 11]. Fitzek et al. showed that conformal protons and photons in accelerated fractionation of 9 GyE for GBM improved the median survival period to 2 months [12]. Iuchi et al. used hypofractionated high-dose IMRT with concurrent and adjuvant TMZ in a phase II trial [13]. However, dose escalation increases the risk of radiation necrosis and the benefit of this approach is unclear.
2 2 J Neurooncol We obtained a median survival period of 21. months for GBM using high-dose proton beam therapy (PBT) concur - rent with nimustine hydrochloride (ACNU) [14, 15]. However, the efficacy and safety of PBT concurrent with TMZ is unknown. Here, we evaluated PBT given with ACNU or TMZ. Material and methods Patients From September 21 to September 212, a total of 15 patients with GBM diagnosed histologically received postoperative radiotherapy at our institute. As conventional radiotherapy, 4 5 Gy in 2 25 fractions were first delivered to the area of T2 hyperintense MRI, with a 2. cm margin. Subsequently, we added 1 2 Gy as a boost to the area with T1 post-contrast enhancement or the tumor bed plus a 2. cm margin, giving a total dose of Gy in 3 fractions. In patients with a poor general condition, such as a Karnofsky performance status (KPS) <4 or old age, consecutive daily treatment of 3 fractions is often difficult. In such cases, the total dose and number of fractions were reduced to shorten the treatment period: typically, a dose of 45 Gy in 15 fractions to the contrast-enhanced area plus a 1 2 cm margin. Of the 15 patients, 119 received conventional radiotherapy: 89 treated with doses from to 1.2 Gy in 3 34 fractions, and 3 treated with lower doses in fewer fractions. The remaining 4 patients (Table 1) desired treatment with hyperfractionated concomitant boost PBT. Written informed consent was obtained from all patients. Before PBT, radiation oncologists and brain surgeons confirmed that predicted radiation necrosis was unlikely to be fatal in all cases. The criterion for this decision was based on the potential resectability of a lesion when brain necrosis was found in the range to be irradiated at 9. Gy (lesion + resected cavity + 5 mm). The patients comprised 24 men and 22 women, and had a median age of 58 years old (range 24 7 years old). The tumor location was the frontal lobe, temporal lobe, parietal lobe and occipital lobe in 23, 1, 3 and 4 patients, respectively. Five patients had a KPS of, 1 had KPS 7, 12 had KPS 8, 11 had KPS 9, and 8 had KPS 1. One patient had undergone biopsy, 14 had received partial resection, and 31 had undergone subtotal resection/gross total resection before radiotherapy. PBT was administered concurrently with ACNU in 23 patients and with TMZ in 23 patients. Combination chemotherapy with ACNU was performed until April 28 and all patients have received TMZ since this date. The first 2 patients were also subjects of a previously reported Phase I/II prospective study [14]. Table 1 Patient characteristics Characteristics ACNU (N = 23) TMZ (N = 23) Age (years) Treatment methods 31 7 (range) 55 (median) Gender Male Female Location Frontal lobe 8 15 Temporal lobe 1 Parietal lobe 2 1 Occipital lobe 3 1 Karnofsky performance status Extent of surgery Biopsy only 1 Partial resection 9 5 Total resection RPA class Class V 7 Class IV 13 9 Class III 4 7 All 4 patients received hyperfractionated concomitant boost proton radiotherapy after surgery. Computed tomography (CT) images taken at 3 mm intervals at the treatment site were used for PBT treatment planning. Proton beams with an energy of 25 MEV were generated by a booster synchrotron at the Proton Medical Research Center (PMRT). The treatment planning system gives dose distributions and settings for the collimator configuration, bolus, and range-shifter thickness. The relative biological effectiveness (RBE) of PBT was assumed to be 1.1. Clinical target volume 1 (CTV1) was defined as the area of contrast enhancement on MRI, CTV2 as the area of contrast enhancement on MRI plus a 1 mm margin, and CTV3 as surrounding edema determined by imaging (T2-weighted or fluid-attenuated inversion recovery MRI) plus a 15 mm margin. MRI was performed immediately before and after surgery in all subjects. Conventional radiotherapy of 5.4 Gy in 28 fractions was delivered to CTV3 in the morning. Additional concomitant boost proton radiotherapy of 23.1 GyE in 14 fractions was delivered to CTV2 more than h after conventional radiotherapy, and proton radiotherapy of 23.1 GyE in 14
3 J Neurooncol fractions was then delivered to CTV1. The planning target volume (PTV) was defined as the CTV plus 5 mm for set up error. The exposure dose was adjusted to 5 Gy for the chiasm and Gy for the brainstem and thalamus. If the dose to an organ at risk exceeded the exposure dose, the margin of the lesion was reduced. Thus, the total doses to PTV1, PTV2 and PTV3 were 9. GyE in 5 fractions, 73.5 GyE in 42 fractions, and 5.4 Gy in 28 fractions, respectively. ACNU was given intravenously at 8 mg/m 2 for 1 day in weeks 1 and 4 of radiotherapy. From 28, concurrent chemotherapy was changed from ACNU to daily TMZ at 75 mg/m 2. Follow-up procedures and evaluation criteria Acute treatment-related toxicities were assessed weekly during treatment. After completion of PBT, the patients were evaluated by physical examinations, MRI, and blood tests every 3 months for the first 2 years and every months thereafter. The Kaplan Meier method was used for calculation of local control and survival rates, and a Log-rank test was performed for evaluation of differences between two categories. Acute and late treatment-related toxicities were assessed using the National Cancer Institute Common Criteria ver. 3. and the RTOG/EORTC late radiation morbidity scoring scheme [1]. A progressive or enhanced lesion on MRI within CTV1 (which received 9. GyE) was defined as an in-field MRI change. A similar change within CTV2 (73.5 GyE) or CTV3 (5.4 GyE) was defined as a border MRI change, and a change outside the irradiated field was defined as an extra-field MRI change. Results All patients received radiotherapy and PBT within 3 months postoperatively. The period between surgery and radiother - apy was days (median 27 days), and radiotherapy and PBT were completed in 37 5 days (median 43 days). At the time of analysis, 13 patients were alive and 33 had died. The median follow-up period for survivors was 42.1 months (range months). Death was due to cancer in 28 patients and to a disease unrelated to tumor recurrence in five patients. The overall 1- and 2-year survival rates for all patients were 82. and 47. %, respectively, and the median survival period was 21.1 months (range months, 95 % CI months). The 1- and 2-year MRI change-free survival rates were 37. and 11. %, respectively, and the median MRI change-free survival period was 8.3 months (range months, 95 % CI months). Overall and MRI change-free survival curves for all patients are shown in Fig. 1. At the last follow-up, 42 patients had a progressive or enhanced lesion on MRI 31 of these cases were diagnosed as tumor recurrence and 11 as radiation necrosis (five in the TMZ group and six in the ACNU group). Of the 31 recur - rence cases,, 1 and 9 were in areas that received irradiation of 9., 73.5 GyE, and 5.4 GyE, respectively. In contrast, 1 of the 11 cases of radiation necrosis occurred in the area irradiated with 9. GyE and one in the area that received 73.5 GyE. The median MRI change-free survival times were.7 (range ) months in recurrence cases and 13.2 (.2 35) months in necrosis cases (Fig. 2). The patients in the ACNU and TMZ groups had similar characteristics (Table 1). In the ACNU group (n = 23), the median follow-up period for survivors was 88. ( ) months. Nineteen patients completed two planned rate Necrosis Recurrence rate Overall survival MRI change (months) 38 1 Recurrence cases (n=31) Overall survival me (median 21.1 months) MRI-change free survival (median 8.3 months) 48 Fig. 1 Kaplan Meier estimates of overall and progression-free sur - vival for all 4 patients P =.2 Radia on necrosis (n=11) (months) 2 1 Fig. 2 Kaplan Meier estimates of progression-free survival in radia - tion necrosis cases (n = 11) and recurrence cases (n = 31)
4 4 J Neurooncol rate TMZ ACNU ACNU group (n=23) MST 21. months TMZ group (n=23) MST 25.7 months (months) P = Fig. 3 Kaplan Meier estimates of overall survival in the TMZ and ACNU groups cycles and four patients had to miss the second cycle of chemotherapy due to acute reactions. In the TMZ group (n = 23), the median follow-up period for survivors was 33.4 ( ) months. Sixteen patients completed daily TMZ and seven patients required breaks due to myelosuppression. The median overall survival times were 21. and 25.7 months in the ACNU and TMZ groups, respectively (p =.59) (Fig. 3). The median MRI change-free survival was.9 months in the ACNU group and 1.4 months in the TMZ group (p =.43). Age, gender, performance status ( 8 vs. 9 1), surgery (subtotal-gross total vs. partialbiopsy), and concurrent chemotherapy (TMZ vs. ACNU) were evaluated as potential predictive factors for overall survival, but none of these factors were significant in univariate and multivariate analyses. Non-hematologic acute toxicity was mild. Only two patients had a grade 3 non-hematologic acute reaction. Grade 2 or 3 non-hematologic acute toxicity occurred in three patients in the ACNU group and 11 patients in the TMZ group. There were 14 cases of hematologic acute toxicity that was probably caused by chemotherapy in the ACNU group: four, seven, one and two patients had grade 4 leukopenia, neutropenia, lymphopenia and thrombocytope - nia, respectively. In the TMZ group, three patients had grade 4 lymphopenia. A summary of adverse events is shown in Table 2. KPS was evaluable in 35 and 1 subjects at 1 and 2 years after irradiation, respectively. Median KPS was 8 ( 1) and (3 1) before and 1 year after irradiation, respectively, and 17 patients had recurrence of GBM, four had brain necrosis, and 14 had neither recurrence nor necrosis. The changes in median KPS were 3 ( to +2), 1 ( 2 to +1) and 1 ( to +2) in these respective groups. In the 1 subjects who were evaluable at 2 years, median KPS was 8 ( 1) and 7 (3 9) before and 2 years after irradiation, respectively; and five patients had recurrence, eight had necrosis, and three had neither. The changes in median KPS were 3 ( 5 to 1), 1 ( 4 to +2) and 2 ( 4 to +1) in the respective groups. Discussion Radiotherapy is standard treatment for high-grade glioma after surgical resection because considerable residual tumor remains in the normal brain. Standard radiotherapy of Gy in 3 fractions with TMZ is typically used [ 8]. SRS/IMRT and particle radiotherapy achieve better dose localization in the tumor volume, and several prospective studies of these new methods have shown that dose escalation is feasible and survival is not inferior to standard schedules [9, 1, 13, 17]. Fitzek et al. showed that accelerated fractionated proton/photon irradiation at 9 GyE for GBM gave median survival of 2 months [12] and we found that accelerated fractionated proton/photon irradiation at 9. GyE concur - rent with ACNU also achieved better survival [14, 15]. For Table 2 Adverse events Event ACNU (N = 23) TMZ (N = 23) Grade 2 Grade 3 Grade 4 Grade 2 Grade 3 Grade 4 Anemia Leukopenia Neutropenia Lymphopenia Thrombocytopenia Nausea and vomiting 2 1 Dermatitis 2 5 Otitis 1 1 Seizure 2
5 J Neurooncol consistency with standard treatment, in 28 we changed ACNU to daily TMZ, without changing the basic PBT and radiotherapy protocols. The results of this study indicate that the change from ACNU to TMZ had no significant impact on MRI change-free and overall survival using a high dose PBT protocol. The follow-up period for survivors differed substantially between the TMZ and ACNU groups because TMZ treatment was only initiated in 28. Several patients in the ACNU group survived for 5 years or longer. Longer follow up is needed to confirm whether survivors in the TMZ group will have a similar course. Mirimanoff et al. and Li et al. showed that recursive partitioning analysis (RPA) could identify significant prognostic factors for GBM [18, 19]. In these reports, RPA III was classified as KPS 9 1 and age <5, and RPA IV was classified as KPS 8 and age <5 or 5 with surgical resection. Overall survival differed among RPA classes III and IV, with median survival of 1.3 and 11.3 months, respectively. The median survival of 21.1 months in the current study was better than that in patients of RPA class III, despite 35 of the 4 patients in our study being in RPA class IV or V. Matsuda et al. reported treatment outcomes of GBM in our hospital from 1998 to 27. Median survival was 17.7 months in 35 subjects treated with ACNU who underwent irradiation at 1.2 Gy, and multivariate analysis showed that high-dose PBT and boron neutron capture therapy were significant good prognostic factors. Local failure after standard radiotherapy of Gy in 3 fractions is common for GBM [7, 8]. However, only six of 31 patients in the current study had recurrence within the 9. GyE area of irradiation and much of this was bor - der recurrence. Fitzek et al. and our previous reports have shown similar failure patterns [12, 14, 15]. These results suggest that a dose of 9 GyE is required to control GBM. In our protocol, 9. GyE was irradiated with only a.5 cm margin for the residual tumor. This margin is clearly insufficient for GBM, but the adequate safety margin for normal brain is unknown with high dose PBT. Matsuo et al. showed that methionine PET (MET-PET) is highly sensitive in the context of brain tumor tissue [19], with residual tumor occasionally detected by MET-PET at more than 2 cm beyond the contrast enhancement on MRI. Iuchi et al. also showed that methionine uptake was significantly correlated with tumor control [2]. Use of these new diagnostic methods is likely to improve target delineation and definition of the extent of the residual tumor. Radiation necrosis is also an important problem. Necrotomy, hyperbaric oxygen therapy, anticoagulants and corti - costeroids are used for treatment of radiation brain necrosis [21], and bevacizumab may provide a new treatment for radiation necrosis [22 24]. We previously found that six of 23 patients treated with PBT concurrent with ACNU who developed radiation necrosis were well controlled by necrotomy and/or bevacizumab [15]. The improved sur - vival and prolonged follow-up period led to five patients developing new radiation necrosis. We now preferentially treat inoperable symptomatic radiation necrosis with bevacizumab. Regarding survival, KPS at 1 and 2 years after irradiation decreased by about ten in patients with brain necrosis, but by about 3 in those with recurrence. There - fore, the effect of brain necrosis on KPS was less than that of recurrence. However, we have no KPS data for irradia - tion at Gy and it will be important to examine KPS after irradiation at this dose. There may be selection bias for tumors located distal to a risk organ such as the brainstem and optic chiasm, but the results of this study support the efficacy of high dose PBT concurrent with chemotherapy. However, the optimal PBT schedule is uncertain. It is clear that 9. GyE is sufficient to control GBM, but a 5-mm margin is not sufficient to cover GBM. Therefore, the total dose may have to be decreased to extend the margins in future clinical trials. However, our results indicate that high dose PBT concurrent with TMZ or ACNU extends the median survival time to 2 months and is well tolerated in carefully selected patients with GBM. Use of MET-PET and bevacizumab may further improve outcomes, and prospective studies of new irradiation meth - ods and combined treatment are warranted. Radiation necrosis is inevitable in long-term survivors. Therefore, prior to PBT, there is a need to predict the level of radiation necrosis and determine that this will not be fatal. Acknowledgments This work was partially supported by grants-inaid for Scientific Research (B) (15H491) and Young Scientists (B) (25814) from the Ministry of Education, Culture, Sports, Science and Technology of Japan. References 1. Walker MD, Strike TA, Sheline GE (1979) An analysis of dose effect relationship in the radiotherapy of malignant gliomas. Int J Radiat Oncol Biol Phys 5: Walker MD, Green SB, Byar DP et al (198) Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 33: Keime-Guibert F, Chinot O, Taillandier L et al (27) Radiotherapy for glioblastoma in the elderly. N Engl J Med 35: Fine HA, Dear KB, Loeffler JS et al (1993) Meta-analysis of radiation therapy with and without adjuvant chemotherapy for malignant gliomas in adults. Cancer 71: Stewart LA (22) Chemotherapy in adult high-grade glioma: a systematic review and meta-analysis of individual patient data from 12 randomised trials. Lancet 359: Athanassiou H, Synodinou M, Maragoudakis E et al (25) Randomized phase II study of temozolomide and radiotherapy compared with radiotherapy alone in newly diagnosed glioblastoma multiforme. J Clin Oncol 23: Stupp R, Mason WP, van den Bent MJ et al (25) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:
6 J Neurooncol 8. Stupp R, Dietrich PY, Ostermann Kraljevic S et al (22) Promising survival for patients with newly diagnosed glioblastoma multiforme treated with concomitant radiation plus temozolomide followed by adjuvant temozolomide. J Clin Oncol 2: Gilbert MR, Dignam JJ, Armstrong TS et al (214) A randomized trial of bevacizumab for newly diagnosed glioblastoma. N Engl Med 37: Chinot OL, Wick W, Mason W et al (214) Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. N Engl Med 37: Tanaka M, Ino Y, Nakagawa K et al (25) High-dose confor - mal radiotherapy for supratentorial malignant glioma: a historical comparison. Lancet : Fitzek MM, Thornton AF, Rabinov JD et al (1999) Accelerated fractionated proton/photon irradiation to 9 cobalt gray equivalent for glioblastoma multiforme: results of a phase II prospective trial. J Neurosurg 91: Iuchi T, Hatano K, Kodama T et al (214) Phase 2 trial of hypofractionated high-dose intensity modulated radiation therapy with concurrent and adjuvant temozolomide for newly diagnosed glioblastoma. Int J Radiat Oncol Biol Phys 88: Mizumoto M, Tsuboi K, Igaki H et al (21) Phase I/II trial of hyperfractionated concomitant boost proton radiotherapy for supratentorial glioblastoma multiforme. Int J Radiat Oncol Biol Phys 77: Mizumoto M, Yamamoto T, Takano S et al (215) Long-term survival after treatment of glioblastoma multiforme with hyper - fractionated concomitant boost proton beam therapy. Pract Radiat Oncol 5:e9 e1 1. Cancer Therapy Evaluation Program (2) Common terminol - ogy criteria for adverse events v3. (CTCAE). Cancer Therapy Evaluation Program, Bethesda, MD Sultanem K, Patrocinio H, Lambert C et al (24) The use of hypofractionated intensity-modulated irradiation in the treatment of glioblastoma multiforme: preliminary results of a prospective trial. Int J Radiat Oncol Biol Phys 58: Mirimanoff RO, Gorlia T, Mason W et al (2) Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 2981/22981-NCIC CE3 phase III randomized trial. J Clin Oncol 24: Matsuo M, Miwa K, Tanaka O et al (212) Impact of [ 11 C]methionine positron emission tomograpy for target definition of glioblastoma multiforme in radiation therapy planning. Int J Radiat Oncol Biol Phys 82: Iuchi T, Hatano K, Uchino Y et al (215) Methionine uptake and required dose to control glioblastoma. Int J Radiat Oncol Biol Phys 93: Bui QC, Lieber M, Withers HR et al (24) The efficacy of hyperbaric oxygen therapy in the treatment of radiation-induced late side effects. Int J Radiat Oncol Biol Phys : Yonezawa S, Miwa K, Shinoda J et al (214) Bevacizumab treatment leads to observable morphological and metabolic changes in brain radiation necrosis. J Neurooncol 119: Lubelski D, Abdullah KG, Weil RJ et al (213) Bevacizumab for radiation necrosis following treatment of high grade glioma: a systematic review of the literature. J Neurooncol 115: Furuse M, Nonoguchi N, Kawabata S et al (213) Bevacizumab treatment for symptomatic radiation necrosis diagnosed by amino acid PET. Jpn J Clin Oncol 43: Matsuda M, Yamamoto T, Ishikawa E et al (211) Prognostic factors in glioblastoma multiforme patients receiving high-dose particle radiotherapy or conventional radiotherapy. Br J Radiol 84:S54 S
doi: /bjr/
doi: 10.1259/bjr/29022270 Prognostic factors in the consecutive institutional series of glioblastoma multiforme patients who received high-dose particle radiotherapy or conventional radiotherapy Masahide
More informationSurvival of High Grade Glioma Patients Treated by Three Radiation Schedules with Chemotherapy: A Retrospective Comparative Study
Original Article Research in Oncology June 2017; Vol. 13, No. 1: 18-22. DOI: 10.21608/resoncol.2017.552.1022 Survival of High Grade Glioma Patients Treated by Three Radiation Schedules with Chemotherapy:
More informationConcomitant (without adjuvant) temozolomide and radiation to treat glioblastoma: A retrospective study
Concomitant (without adjuvant) temozolomide and radiation to treat glioblastoma: A retrospective study T Sridhar 1, A Gore 1, I Boiangiu 1, D Machin 2, R P Symonds 3 1. Department of Oncology, Leicester
More informationHypofractionated radiation therapy for glioblastoma
Hypofractionated radiation therapy for glioblastoma Luis Souhami, MD, FASTRO Professor McGill University Department of Oncology, Division of Radiation Oncology Montreal Canada McGill University Health
More informationCollection of Recorded Radiotherapy Seminars
IAEA Human Health Campus Collection of Recorded Radiotherapy Seminars http://humanhealth.iaea.org The Role of Radiosurgery in the Treatment of Gliomas Luis Souhami, MD Professor Department of Radiation
More informationClinical Study Hypofractionated High-Dose Irradiation with Positron Emission Tomography Data for the Treatment of Glioblastoma Multiforme
BioMed Research International Volume 14, Article ID 26, 9 pages http://dx.doi.org/.1155/14/26 Clinical Study Hypofractionated High-Dose Irradiation with Positron Emission Tomography Data for the Treatment
More information3-D conformal radiotherapy with concomitant and adjuvant temozolomide for patients with glioblastoma multiforme and evaluation of prognostic factors
research article 213 3-D conformal radiotherapy with concomitant and adjuvant temozolomide for patients with glioblastoma multiforme and evaluation of prognostic factors Yilmaz Tezcan and Mehmet Koc Department
More informationDOES RADIOTHERAPY TECHNIQUE / DOSE / FRACTIONATION REALLY MATTER? YES
DOES RADIOTHERAPY TECHNIQUE / DOSE / FRACTIONATION REALLY MATTER? YES Marco Krengli Radiotherapy, Department of Translational Medicine, University of Piemonte Orientale A. Avogadro THE STANDARD OF CARE
More informationElderly Patients with Glioblastoma Multiforme Treated with Concurrent Temozolomide and Standard- versus Abbreviated-Course Radiotherapy
Elderly Patients with Glioblastoma Multiforme Treated with Concurrent Temozolomide and Standard- versus Abbreviated-Course Radiotherapy Christine N Chang-Halpenny, MD; Jekwon Yeh, MD; Winston W Lien, MD
More informationCitation Pediatrics international (2015), 57.
Title Long-term efficacy of bevacizumab a pediatric glioblastoma. Umeda, Katsutsugu; Shibata, Hirofum Author(s) Hiramatsu, Hidefumi; Arakawa, Yoshi Nishiuchi, Ritsuo; Adachi, Souichi; Ken-Ichiro Citation
More informationScottish Medicines Consortium
Scottish Medicines Consortium temozolomide 5, 20, 100 and 250mg capsules (Temodal ) Schering Plough UK Ltd No. (244/06) New indication: for the treatment of newly diagnosed glioblastoma multiforme concomitantly
More informationCarmustine implants and Temozolomide for the treatment of newly diagnosed high grade glioma
National Institute for Health and Clinical Excellence Health Technology Appraisal Carmustine implants and Temozolomide for the treatment of newly diagnosed high grade glioma Personal statement Conventional
More informationRadiation and concomitant chemotherapy for patients with glioblastoma multiforme
Chinese Journal of Cancer Review Radiation and concomitant chemotherapy for patients with glioblastoma multiforme Salvador Villà 1, Carme Balañà 2 and Sílvia Comas 1 Abstract Postoperative external beam
More informationONCOLOGY LETTERS 10: , 2015
ONCOLOGY LETTERS 10: 201-205, 2015 Proton beam therapy for locally advanced and unresectable (T4bN0M0) squamous cell carcinoma of the ethmoid sinus: A report of seven cases and a literature review TAKASHI
More informationTHE EFFECTIVE OF BRAIN CANCER AND XAY BETWEEN THEORY AND IMPLEMENTATION. Mustafa Rashid Issa
THE EFFECTIVE OF BRAIN CANCER AND XAY BETWEEN THEORY AND IMPLEMENTATION Mustafa Rashid Issa ABSTRACT: Illustrate malignant tumors that form either in the brain or in the nerves originating in the brain.
More informationWe have previously reported good clinical results
J Neurosurg 113:48 52, 2010 Gamma Knife surgery as sole treatment for multiple brain metastases: 2-center retrospective review of 1508 cases meeting the inclusion criteria of the JLGK0901 multi-institutional
More informationDepartment of Medical Oncology, National Cancer Institute of Aviano, Aviano (PN) Italy 3
WCRJ 2014; 1 (4): e401 RADIOCHEMOTHERAPY FOR UNRESECTABLE GLIOBLASTOMA MULTIFORME: A MONO- INSTITUTIONAL EXPERIENCE M. COLELLA 1, F. FIORICA 1, P. API 1, A. STEFANELLI 1, B. URBINI 2, A. SGUALDO 1, D.
More informationORIGINAL PAPERS. The Impact of Surgery on the Efficacy of Adjuvant Therapy in Glioblastoma Multiforme
ORIGINAL PAPERS Adv Clin Exp Med 2015, 24, 2, 279 287 DOI: 10.17219/acem/40456 Copyright by Wroclaw Medical University ISSN 1899 5276 Anna Brzozowska 1, 2, A D, Anna Toruń 3, G, Maria Mazurkiewicz1, 2,
More information21/03/2017. Disclosure. Practice Changing Articles in Neuro Oncology for 2016/17. Gliomas. Objectives. Gliomas. No conflicts to declare
Practice Changing Articles in Neuro Oncology for 2016/17 Disclosure No conflicts to declare Frances Cusano, BScPharm, ACPR April 21, 2017 Objectives Gliomas To describe the patient selection, methodology
More informationZurich Open Repository and Archive. Long-term survival of glioblastoma patients treated with radiotherapy and lomustine plus temozolomide
University of Zurich Zurich Open Repository and Archive Winterthurerstr. 19 CH-857 Zurich http://www.zora.uzh.ch Year: 29 Long-term survival of glioblastoma patients treated with radiotherapy and lomustine
More informationA Population-Based Study on the Uptake and Utilization of Stereotactic Radiosurgery (SRS) for Brain Metastasis in Nova Scotia
A Population-Based Study on the Uptake and Utilization of Stereotactic Radiosurgery (SRS) for Brain Metastasis in Nova Scotia Gaurav Bahl, Karl Tennessen, Ashraf Mahmoud-Ahmed, Dorianne Rheaume, Ian Fleetwood,
More informationSurvival Analysis of Glioblastoma Multiforme
DOI:10.22034/APJCP.2018.19.9.2613 RESEARCH ARTICLE Editorial Process: Submission:04/24/2018 Acceptance:08/19/2018 Supapan Witthayanuwat, Montien Pesee*, Chunsri Supaadirek, Narudom Supakalin, Komsan Thamronganantasakul,
More informationPRESURGICAL PLANNING. Strongly consider neuropsychological evaluation before functional imaging study Strongly consider functional imaging study
NOTE: Consider Clinical Trials as treatment options for eligible patients. Page 1 of 6 RADIOLOGICAL PRESENTATION PRESURGICAL PLANNING TREATMENT Imaging study suggestive of glioma 1 Left hemisphere speech/motor
More informationIncidence of Early Pseudo-progression in a Cohort of Malignant Glioma Patients Treated With Chemoirradiation With Temozolomide
405 Incidence of Early Pseudo-progression in a Cohort of Malignant Glioma Patients Treated With Chemoirradiation With Temozolomide Walter Taal, MD 1 Dieta Brandsma, MD, PhD 1 Hein G. de Bruin, MD, PhD
More informationTreatment results of proton beam therapy with chemo-radiotherapy for stage I-III esophageal cancer
Treatment results of proton beam therapy with chemo-radiotherapy for stage I-III esophageal cancer Nobukazu Fuwa 1, Akinori Takada 2 and Takahiro Kato 3 1;Departments of Radiology, Hyogo Ion Beam Medical
More informationPROCARBAZINE, lomustine, and vincristine (PCV) is
RAPID PUBLICATION Procarbazine, Lomustine, and Vincristine () Chemotherapy for Anaplastic Astrocytoma: A Retrospective Review of Radiation Therapy Oncology Group Protocols Comparing Survival With Carmustine
More informationZurich Open Repository and Archive. Long-term survival of glioblastoma patients treated with radiotherapy and lomustine plus temozolomide
University of Zurich Zurich Open Repository and Archive Winterthurerstr. 190 CH-8057 Zurich http://www.zora.uzh.ch Year: 2009 Long-term survival of glioblastoma patients treated with radiotherapy and lomustine
More informationJ Clin Oncol 27: by American Society of Clinical Oncology INTRODUCTION
VOLUME 27 NUMBER 8 MARCH 10 2009 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Recurrence Pattern After Temozolomide Concomitant With and Adjuvant to Radiotherapy in Newly Diagnosed Patients
More informationSurvival Following CyberKnife Radiosurgery and Hypofractionated Radiotherapy for Newly Diagnosed Glioblastoma Multiforme
Technology in Cancer Research and Treatment ISSN 1533-0346 Volume 7, Number 3, June 2008 Adenine Press (2008) Survival Following CyberKnife Radiosurgery and Hypofractionated Radiotherapy for Newly Diagnosed
More informationProtons for Head and Neck Cancer. William M Mendenhall, M.D.
Protons for Head and Neck Cancer William M Mendenhall, M.D. Protons for Head and Neck Cancer Potential Advantages: Reduce late complications via more conformal dose distributions Likely to be the major
More informationTemozolomide Concomitant and Adjuvant to Radiotherapy in Elderly Patients With Glioblastoma
Temozolomide Concomitant and Adjuvant to Radiotherapy in Elderly Patients With Glioblastoma Correlation With MGMT Promoter Methylation Status Alba A. Brandes, MD 1 ; Enrico Franceschi, MD 1 ; Alicia Tosoni,
More informationEvaluation of Three-dimensional Conformal Radiotherapy and Intensity Modulated Radiotherapy Techniques in High-Grade Gliomas
1 Carol Boyd Comprehensive Case Study July 11, 2013 Evaluation of Three-dimensional Conformal Radiotherapy and Intensity Modulated Radiotherapy Techniques in High-Grade Gliomas Abstract: Introduction:
More informationNewcastle Neuro-oncology Team Audit of Outcome of Glioblastoma Multiforme Chemoradiotherapy Treatment
Newcastle Neuro-oncology Team Audit of Outcome of Glioblastoma Multiforme Chemoradiotherapy Treatment Jennifer Wright Neurosurgery SSC Audit Team Jennifer Wright, Rachel Tresman, Cyril Dubois, Surash Surash,
More informationInstitute of Oncology & Radiobiology. Havana, Cuba. INOR
Institute of Oncology & Radiobiology. Havana, Cuba. INOR 1 Transition from 2-D 2 D to 3-D 3 D conformal radiotherapy in high grade gliomas: : our experience in Cuba Chon. I, MD - Chi. D, MD - Alert.J,
More informationPaolo Tini 1,3 M.D. :
Correlazione tra espressione di Epidermal Growth Factor Receptor (EGFR) e Patterns di recidiva/progressione di malattia dopo trattamento radio-chemioterapico in pazienti affetti da Glioblastoma (GB). Paolo
More informationAn international study under the guidance of the European Organization
2617 COMMENTARY Chemotherapy for Glioblastoma Is Costly Better? Ute Linz, MD, PhD Juelich Research Center, IKP/INB, Juelich, Germany. Address for reprints: Ute Linz, MD, PhD, Forschungszentrum J ulich
More informationEfficacy of Treatment for Glioblastoma Multiforme in Elderly Patients (65+): A Retrospective Analysis
Efficacy of Treatment for Glioblastoma Multiforme in Elderly Patients (65+): A Retrospective Analysis Igal Kushnir MD 1 * and Tzahala Tzuk-Shina MD 2 1 Oncology Insitute, Tel Aviv Sourasky Medical Center,
More informationConcurrent Chemoradiotherapy Versus Radiotherapy Alone for Biopsy-Only Glioblastoma Multiforme
Concurrent Chemoradiotherapy Versus Radiotherapy Alone for Biopsy-Only Glioblastoma Multiforme Adam J. Kole, MD, PhD 1 ; Henry S. Park, MD, MPH 1 ; Debra N. Yeboa, MD 1 ; Charles E. Rutter, MD 1 ; Christopher
More informationTreatment and outcomes for glioblastoma in elderly compared with non-elderly patients: a population-based study
ORIGINAL ARTICLE Treatment and outcomes for glioblastoma in elderly compared with non-elderly patients: a population-based study E.R. Morgan md,* A. Norman md, K. Laing md, and M.D. Seal md ABSTRACT Purpose
More informationBevacizumab rescue therapy extends the survival in patients with recurrent malignant glioma
Original Article Bevacizumab rescue therapy extends the survival in patients with recurrent malignant glioma Lin-Bo Cai, Juan Li, Ming-Yao Lai, Chang-Guo Shan, Zong-De Lian, Wei-Ping Hong, Jun-Jie Zhen,
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM ANAPLASTIC GLIOMAS CNS Site Group Anaplastic Gliomas Author: Dr. Norm Laperriere Date: February 20, 2018 1. INTRODUCTION
More informationSelecting the Optimal Treatment for Brain Metastases
Selecting the Optimal Treatment for Brain Metastases Clinical Practice Today CME Co-provided by Learning Objectives Upon completion, participants should be able to: Understand the benefits, limitations,
More informationBevacizumab in combination with temozolomide and regional radiation therapy for up-front treatment of patients with newly-diagnosed glioblastoma
Bevacizumab in combination with temozolomide and regional radiation therapy for up-front treatment of patients with newly-diagnosed glioblastoma Design and analysis of single-arm Phase II clinical trial
More informationCarbon Ion Radiotherapy for Skull Base and Paracervical Chordomas
Carbon Ion Radiotherapy for Skull Base and Paracervical Chordomas Azusa Hasegawa, Jun-etsu Mizoe and Hirohiko Tsujii Research Center Hospital for Charged Particle Therapy National Institute of Radiological
More informationTemozolomide with Radiotherapy for the Treatment of Malignant Gliomas, Center Experience
Temozolomide with Radiotherapy for the Treatment of Malignant Gliomas, Center Experience *Ehab Abdou and **Mohamed Gaafar *Department of Radiation Oncology, Faculty of Medicine, Al-Azhar University, Cairo,
More informationPrognostic significance of surgery and radiation therapy in cases of anaplastic astrocytoma: retrospective analysis of 170 cases
J Neurosurg 106:575 581, 2007 Prognostic significance of surgery and radiation therapy in cases of anaplastic astrocytoma: retrospective analysis of 170 cases TAKUMA NOMIYA, M.D., PH.D., 1 KENJI NEMOTO,
More informationContemporary Management of Glioblastoma
Contemporary Management of Glioblastoma Incidence Rates of Primary Brain Tumors Central Brain Tumor Registry of the United States, 1992-1997 100 Number of Cases per 100,000 Population 10 1 0.1 x I x I
More informationThe Role of Radiation Therapy in the Treatment of Brain Metastases. Matthew Cavey, M.D.
The Role of Radiation Therapy in the Treatment of Brain Metastases Matthew Cavey, M.D. Objectives Provide information about the prospective trials that are driving the treatment of patients with brain
More informationOncological Management of Brain Tumours. Anna Maria Shiarli SpR in Clinical Oncology 15 th July 2013
Oncological Management of Brain Tumours Anna Maria Shiarli SpR in Clinical Oncology 15 th July 2013 Outline General considerations of Primary Brain Tumours: epidemiology, pathology, presentation. Diagnosis
More informationSee the corresponding editorial in this issue, pp 1 2. J Neurosurg 115:3 8, An extent of resection threshold for newly diagnosed glioblastomas
See the corresponding editorial in this issue, pp 1 2. J Neurosurg 115:3 8, 2011 An extent of resection threshold for newly diagnosed glioblastomas Clinical article Nader Sanai, M.D., 1 Mei-Yin Polley,
More informationTarget Delineation in Gliomas. Prof PK Julka Department of Radiotherapy and Oncology AIIMS, New Delhi
Target Delineation in Gliomas Prof PK Julka Department of Radiotherapy and Oncology AIIMS, New Delhi 1 What is a glioma? A primary brain tumour that originated from a cell of the nervous system 2 Recommendations:
More informationSUCCESSFUL TREATMENT OF METASTATIC BRAIN TUMOR BY CYBERKNIFE: A CASE REPORT
SUCCESSFUL TREATMENT OF METASTATIC BRAIN TUMOR BY CYBERKNIFE: A CASE REPORT Cheng-Ta Hsieh, 1 Cheng-Fu Chang, 1 Ming-Ying Liu, 1 Li-Ping Chang, 2 Dueng-Yuan Hueng, 3 Steven D. Chang, 4 and Da-Tong Ju 1
More informationArecent randomized controlled trial (RCT) established
Neuro-Oncology 12(2):190 198, 2010. doi:10.1093/neuonc/nop004 NEURO-ONCOLOGY The timing of cranial radiation in elderly patients with newly diagnosed glioblastoma multiforme Rose Lai, Dawn L. Hershman,
More informationGoing Past the Data for Temozolomide. J. Lee Villano, M.D., Ph.D., Nathalie Letarte, B.Pharm, M.Sc, Linda R. Bressler, Pharm. D.
Going Past the Data for Temozolomide J. Lee Villano, M.D., Ph.D., Nathalie Letarte, B.Pharm, M.Sc, Linda R. Bressler, Pharm. D. Departments of Medicine (JLV), Neurosurgery (JLV) and Pharmacy Practice (LRB)
More informationNCCP Chemotherapy Regimen. Temozolomide with Radiotherapy (RT) and Adjuvant Therapy
Temozolomide with Radiotherapy (RT) INDICATIONS FOR USE: Regimen Code ISMO Contributor: Prof Maccon Keane Page 1 of 6 *Reimbursement Status INDICATION ICD10 Adult patients with newly-diagnosed glioblastoma
More informationGlioblastoma (GBM) is the most common and
Neuro-Oncology 12(6):595 602, 2010. doi:10.1093/neuonc/noq008 Advance Access publication February 11, 2010 NEURO-ONCOLOGY Prolonged survival for patients with newly diagnosed, inoperable glioblastoma with
More informationRadiotherapy and Brain Metastases. Dr. K Van Beek Radiation-Oncologist BSMO annual Meeting Diegem
Radiotherapy and Brain Metastases Dr. K Van Beek Radiation-Oncologist BSMO annual Meeting Diegem 24-02-2017 Possible strategies Watchful waiting Surgery Postop RT to resection cavity or WBRT postop SRS
More informationRadiotherapy for liver cancer
Received: 7 November 2015 Accepted: 10 March 2016 DOI: 10.1002/jgf2.19 REVIEW ARTICLE Radiotherapy for liver cancer Nobuyoshi Fukumitsu MD Toshiyuki Okumura MD Hideyuki Sakurai MD Proton Medical Research
More informationDefining pseudoprogression in glioblastoma multiforme
European Journal of Neurology 2013, 20: 1335 1341 CME ARTICLE doi:10.1111/ene.12192 Defining pseudoprogression in glioblastoma multiforme E. Van Mieghem a, A. Wozniak b, Y. Geussens c, J. Menten c, S.
More informationPTCOG 46. Educational Workshop Session IV. Head & Neck CLINICAL. J. Mizoe (NIRS, Japan)
PTCOG 46 Educational Workshop Session IV CLINICAL Head & Neck J. Mizoe (NIRS, Japan) Photon X-Ray γ-ray Fast Neutron Non-Charged Radiation Electron Proton Helium Light Ion Heavy Particle Carbon Neon Argon
More informationSBRT in early stage NSCLC
SBRT in early stage NSCLC Optimal technique and tumor dose Frank Zimmermann Clinic of Radiotherapy and Radiation Oncology University Hospital Basel Petersgraben 4 CH 4031 Basel radioonkologiebasel.ch Techniques
More informationRadiotherapy in the management of optic pathway gliomas
Turkish Journal of Cancer Vol.30/ No.1/2000 Radiotherapy in the management of optic pathway gliomas FARUK ZORLU, FERAH YILDIZ, MURAT GÜRKAYNAK, FADIL AKYOL, İ. LALE ATAHAN Department of Radiation Oncology,
More informationBrain Tumor Treatment
Scan for mobile link. Brain Tumor Treatment Brain Tumors Overview A brain tumor is a group of abnormal cells that grows in or around the brain. Tumors can directly destroy healthy brain cells. They can
More informationSurvival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery
ORIGINAL ARTICLE Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery Ann C. Raldow, BS,* Veronica L. Chiang, MD,w Jonathan P.
More informationRuolo dell imaging nella pianificazione del trattamento
Simposio AIRO-SIRM: Diagnostica per immagini morfologica e funzionale nella stadiazione, terapia e follow-up dei sarcomi delle parti molli Ruolo dell imaging nella pianificazione del trattamento Marco
More informationUniversity of Zurich. Temozolomide and MGMT forever? Zurich Open Repository and Archive. Weller, M. Year: 2010
University of Zurich Zurich Open Repository and Archive Winterthurerstr. 190 CH-8057 Zurich Year: 2010 Temozolomide and MGMT forever? Weller, M Weller, M (2010). Temozolomide and MGMT forever? Neuro-Oncology,
More informationORIGINAL ARTICLE GAMMA KNIFE STEREOTACTIC RADIOSURGERY FOR SALIVARY GLAND NEOPLASMS WITH BASE OF SKULL INVASION FOLLOWING NEUTRON RADIOTHERAPY
ORIGINAL ARTICLE GAMMA KNIFE STEREOTACTIC RADIOSURGERY FOR SALIVARY GLAND NEOPLASMS WITH BASE OF SKULL INVASION FOLLOWING NEUTRON RADIOTHERAPY James G. Douglas, MD, MS, 1,2 Robert Goodkin, MD, 1,2 George
More informationNordic Society for Gynecological Oncology Advisory Board of Radiotherapy
Nordic Society for Gynecological Oncology Advisory Board of Radiotherapy Guidelines for postoperative irradiation of cervical cancer Contents: 1. Treatment planning for EBRT. 2 2. Target definition for
More informationSystemic Treatment. Third International Neuro-Oncology Course. 23 May 2014
Low-Grade Astrocytoma of the CNS: Systemic Treatment Third International Neuro-Oncology Course São Paulo, Brazil 23 May 2014 John de Groot, MD Associate Professor, Neuro-Oncology UT MD Anderson Cancer
More informationLynn S. Ashby 1*, Kris A. Smith 2 and Baldassarre Stea 3
Ashby et al. World Journal of Surgical Oncology (2016) 14:225 DOI 10.1186/s12957-016-0975-5 REVIEW Gliadel wafer implantation combined with standard radiotherapy and concurrent followed by adjuvant temozolomide
More informationIntensity modulated radiotherapy (IMRT) for treatment of post-operative high grade glioma in the right parietal region of brain
1 Carol Boyd March Case Study March 11, 2013 Intensity modulated radiotherapy (IMRT) for treatment of post-operative high grade glioma in the right parietal region of brain History of Present Illness:
More informationand Strength of Recommendations
ASTRO with ASCO Qualifying Statements in Bold Italics s patients with T1-2, N0 non-small cell lung cancer who are medically operable? 1A: Patients with stage I NSCLC should be evaluated by a thoracic surgeon,
More informationTechnology appraisal guidance Published: 27 June 2007 nice.org.uk/guidance/ta121
Carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma Technology appraisal guidance Published: 27 June 2007 nice.org.uk/guidance/ta121 NICE 2018. All rights reserved.
More informationGl i o b l a s t o m a multiforme is the most common
J Neurosurg 110:583 588, 2009 Gliadel (BCNU) wafer plus concomitant temozolomide therapy after primary resection of glioblastoma multiforme Clinical article Ma t t h e w J. McGi r t, M.D., 1 Kh o i D.
More informationRadiation Therapy for Soft Tissue Sarcomas
Radiation Therapy for Soft Tissue Sarcomas Alexander R. Gottschalk, MD, PhD Assistant Professor, Radiation Oncology University of California, San Francisco 1/25/08 NCI: limb salvage vs. amputation 43 patients
More informationRole of protons, heavy ions and BNCT in brain tumors
Role of protons, heavy ions and BNCT in brain tumors Prof G K Rath Head, NCI (AIIMS-2) Chief, Dr. BRA IRCH, Professor Radiation Oncology All India Institute of Medical Sciences, New Delhi 1 Overview of
More informationA comparative study of dose distribution of PBT, 3D-CRT and IMRT for pediatric brain tumors
Takizawa et al. Radiation Oncology (2017) 12:40 DOI 10.1186/s13014-017-0775-2 RESEARCH A comparative study of dose distribution of PBT, 3D-CRT and IMRT for pediatric brain tumors Daichi Takizawa 1*, Masashi
More informationClinically Proven Metabolically-Guided TomoTherapy SM Treatments Advancing Cancer Care
Clinically Proven Metabolically-Guided TomoTherapy SM Treatments Advancing Cancer Care Institution: San Raffaele Hospital Milan, Italy By Nadia Di Muzio, M.D., Radiotherapy Department (collaborators: Berardi
More informationDose escalation for NSCLC using conformal RT: 3D and IMRT. Hasan Murshed
Dose escalation for NSCLC using conformal RT: 3D and IMRT. Hasan Murshed Take home message Preliminary data shows CRT technique in NSCLC allows dose escalation to an unprecedented level maintaining cancer
More informationSurvival Outcomes with Short-Course Radiotherapy in Elderly Patients with Glioblastoma: Data from a Randomized Phase III Trial
Accepted Manuscript Survival Outcomes with Short-Course Radiotherapy in Elderly Patients with Glioblastoma: Data from a Randomized Phase III Trial Douglas Guedes de Castro, Juliana Matiello, Wilson Roa,
More informationProtocol of Radiotherapy for Head and Neck Cancer
106 年 12 月修訂 Protocol of Radiotherapy for Head and Neck Cancer Indication of radiotherapy Indication of definitive radiotherapy with or without chemotherapy (1) Resectable, but medically unfit, or high
More informationdoi: /j.radonc
doi: 10.1016/j.radonc.2009.02.009 Boron neutron capture therapy for newly diagnosed glioblastoma Tetsuya Yamamoto MD, PhD, Kei Nakai MD, PhD, Teruyoshi Kageji MD, PhD, Hiroaki Kumada PhD, Kiyoshi Endo
More informationTreatment outcomes and prognostic factors of gallbladder cancer patients after postoperative radiation therapy
Korean J Hepatobiliary Pancreat Surg 2011;15:152-156 Original Article Treatment outcomes and prognostic factors of gallbladder cancer patients after postoperative radiation therapy Suzy Kim 1,#, Kyubo
More informationNon-small cell lung cancer (NSCLC) is a common cause
ORIGINAL ARTICLE Results of Proton Beam Therapy without Concurrent Chemotherapy for Patients with Unresectable Stage III Non-small Cell Lung Cancer Yoshiko Oshiro, MD,* Masashi Mizumoto, MD,* Toshiyuki
More informationRadiotherapy for Patients with Symptomatic Intramedullary Spinal Cord Metastasis
J. Radiat. Res., 52, 641 645 (2011) Regular Paper Radiotherapy for Patients with Symptomatic Intramedullary Spinal Cord Metastasis Haruko HASHII 1,4 *, Masashi MIZUMOTO 1,4 *, Ayae KANEMOTO 1,4, Hideyuki
More informationStereotactic radiotherapy
Stereotactic radiotherapy Influence of patient positioning and fixation on treatment planning - clinical results Frank Zimmermann Institut für Radioonkologie Universitätsspital Basel Petersgraben 4 CH
More informationPractice of Interferon Therapy
Interferon Therapy Practice of Interferon Therapy Brain tumor JMAJ 47(1): 18 23, 2004 Toshihiko WAKABAYASHI* and Jun YOSHIDA** *Associate Professor, Center for Genetic and Regenerative Medicine, Nagoya
More informationBackground. Central nervous system (CNS) tumours. High-grade glioma
25 4. Central nervous system (CNS) tumours Background Two important considerations underpin the choice of treatment fractionation in neurooncology. First, the results of treatment vary widely and, second,
More informationInterferon β and temozolomide combination therapy for temozolomide monotherapy refractory malignant gliomas
MOLECULAR AND CLINICAL ONCOLOGY 3: 909-913, 2015 Interferon β and temozolomide combination therapy for temozolomide monotherapy refractory malignant gliomas HIROSHI KAWAJI, TSUTOMU TOKUYAMA, TOMOHIRO YAMASAKI,
More informationPrior to 1993, the only data available in the medical
Neuro-Oncology Prospective clinical trials of intracranial low-grade glioma in adults and children Edward G. Shaw 1 and Jeffrey H. Wisoff Department of Radiation Oncology, Wake Forest University School
More informationFive Years Comprehensive Experience in Proton Radiotherapy in PMRC Tsukuba
PTCOG 47 Jacksonville, Florida 2008.05.22 Five Years Comprehensive Experience in Proton Radiotherapy in PMRC Tsukuba Koji Tsuboi M.D., Ph.D. Proton Medical Research Center, University of Tsukuba, JAPAN
More informationRetrospective Study of The Corticosteroids Administration in Glioblastoma Patients as A Prognostic Factor in The Disease
The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (5), Page 4551-4555 Retrospective Study of The Corticosteroids Administration in Glioblastoma Patients as A Prognostic Factor in The Disease
More informationCILENT P Leblond, DIPG Meeting, Barcelone 2012
CILENT-0902 Cilengitide (EMD121974) in combination with irradiation in children and adolescents with newly diagnosed diffuse intrinsic brainstem glioma : Phase I Study P Leblond, DIPG Meeting, Barcelone
More information1. Introduction. Correspondence should be addressed to Christopher M. Lee; Received 9 July 2013; Accepted 27 August 2013
Case Reports in Oncological Medicine Volume 2013, Article ID 431857, 5 pages http://dx.doi.org/10.1155/2013/431857 Case Report Long-Term Survival and Improved Quality of Life following Multiple Repeat
More informationEvaluation of Whole-Field and Split-Field Intensity Modulation Radiation Therapy (IMRT) Techniques in Head and Neck Cancer
1 Charles Poole April Case Study April 30, 2012 Evaluation of Whole-Field and Split-Field Intensity Modulation Radiation Therapy (IMRT) Techniques in Head and Neck Cancer Abstract: Introduction: This study
More informationLaboratory data from the 1970s first showed that malignant melanoma
2265 Survival by Radiation Therapy Oncology Group Recursive Partitioning Analysis Class and Treatment Modality in Patients with Brain Metastases from Malignant Melanoma A Retrospective Study Jeffrey C.
More informationProtocol of Radiotherapy for Breast Cancer
107 年 12 月修訂 Protocol of Radiotherapy for Breast Cancer Indication of radiotherapy Indications for Post-Mastectomy Radiotherapy (1) Axillary lymph node 4 positive (2) Axillary lymph node 1-3 positive:
More informationUniversity of Alberta. Evaluation of Concomitant Temozolomide Treatment in Glioblastoma Multiforme Patients in Two Canadian Tertiary Care Centers
University of Alberta Evaluation of Concomitant Temozolomide Treatment in Glioblastoma Multiforme Patients in Two Canadian Tertiary Care Centers by Ibrahim Alnaami A thesis submitted to the Faculty of
More informationAytul OZGEN 1, *, Mutlu HAYRAN 2 and Fatih KAHRAMAN 3 INTRODUCTION
Journal of Radiation Research, 2012, 53, 916 922 doi: 10.1093/jrr/rrs056 Advance Access Publication 21 August 2012 Mean esophageal radiation dose is predictive of the grade of acute esophagitis in lung
More informationModeling the effects of resection, radiation and chemotherapy in glioblastoma
J Neurooncol (09) 91:287 293 DOI 10.1007/s11060-008-9710-6 CLINICAL STUDY - PATIENT STUDY Modeling the effects of resection, radiation and chemotherapy in glioblastoma Jianjun Paul Tian Æ Avner Friedman
More information