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Title: A phase II trial of accelerated radiotherapy using weekly stereotactic conformal boost for supratentorial glioblastoma multiforme: RTOG 0023

Abstract

Purpose: This phase II trial was performed to assess the feasibility, toxicity, and efficacy of dose-intense accelerated radiation therapy using weekly fractionated stereotactic radiotherapy (FSRT) boost for patients with glioblastoma multiforme (GBM). Methods and Materials: Patients with histologically confirmed GBM with postoperative enhancing tumor plus tumor cavity diameter <60 mm were enrolled. A 50-Gy dose of standard radiation therapy (RT) was given in daily 2-Gy fractions. In addition, patients received four FSRT treatments, once weekly, during Weeks 3 to 6. FSRT dosing of either 5 Gy or 7 Gy per fraction was given for a cumulative dose of 70 or 78 Gy in 29 (25 standard RT + 4 FSRT) treatments over 6 weeks. After the RT course, carmustine (BCNU) at 80 mg/m{sup 2} was given for 3 days, every 8 weeks, for 6 cycles. Results: A total of 76 patients were analyzed. Toxicity included: 3 Grade 4 chemotherapy, 3 acute Grade 4 radiotherapy, and 1 Grade 3 late. The median survival time was 12.5 months. No survival difference is seen when compared with the RTOG historical database. Patients with gross total resection (41%) had a median survival time of 16.6 months vs. 12.0 months for historic controls with grossmore » total resection (p = 0.14). Conclusion: This first, multi-institutional FSRT boost trial for GBM was feasible and well tolerated. There is no significant survival benefit using this dose-intense RT regimen. Subset analysis revealed a trend toward improved outcome for GTR patients suggesting that patients with minimal disease burden may benefit from this form of accelerated RT.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8];  [9];  [10]
  1. Medical College of Virginia/Virginia Commonwealth University, Richmond, VA (United States)
  2. Radiation Therapy Oncology Group (RTOG) Headquarters, Philadelphia, PA (United States)
  3. LDS Hospital, Salt Lake City, UT (United States)
  4. University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
  5. Massachusetts General Hospital, Boston, MA (United States)
  6. Medical College of Wisconsin, Milwaukee, WI (United States)
  7. McGill University, Montreal, Quebec (Canada)
  8. University of California, Davis, Davis, CA (United States)
  9. Virginia Mason Medical Center, Seattle, WA (United States)
  10. University of Wisconsin School of Medicine, Madison, WI (United States)
Publication Date:
OSTI Identifier:
20850024
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 65; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2006.02.042; PII: S0360-3016(06)00372-5; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; GLIOMAS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SURGERY; SURVIVAL TIME; TOXICITY

Citation Formats

Cardinale, Robert, Won, Minhee M.A., Choucair, Ali, Gillin, Michael, Chakravarti, Arnab, Schultz, Christopher, Souhami, Luis, Chen, Allan, Pham, Huong, and Mehta, Minesh. A phase II trial of accelerated radiotherapy using weekly stereotactic conformal boost for supratentorial glioblastoma multiforme: RTOG 0023. United States: N. p., 2006. Web. doi:10.1016/j.ijrobp.2006.02.042.
Cardinale, Robert, Won, Minhee M.A., Choucair, Ali, Gillin, Michael, Chakravarti, Arnab, Schultz, Christopher, Souhami, Luis, Chen, Allan, Pham, Huong, & Mehta, Minesh. A phase II trial of accelerated radiotherapy using weekly stereotactic conformal boost for supratentorial glioblastoma multiforme: RTOG 0023. United States. https://doi.org/10.1016/j.ijrobp.2006.02.042
Cardinale, Robert, Won, Minhee M.A., Choucair, Ali, Gillin, Michael, Chakravarti, Arnab, Schultz, Christopher, Souhami, Luis, Chen, Allan, Pham, Huong, and Mehta, Minesh. 2006. "A phase II trial of accelerated radiotherapy using weekly stereotactic conformal boost for supratentorial glioblastoma multiforme: RTOG 0023". United States. https://doi.org/10.1016/j.ijrobp.2006.02.042.
@article{osti_20850024,
title = {A phase II trial of accelerated radiotherapy using weekly stereotactic conformal boost for supratentorial glioblastoma multiforme: RTOG 0023},
author = {Cardinale, Robert and Won, Minhee M.A. and Choucair, Ali and Gillin, Michael and Chakravarti, Arnab and Schultz, Christopher and Souhami, Luis and Chen, Allan and Pham, Huong and Mehta, Minesh},
abstractNote = {Purpose: This phase II trial was performed to assess the feasibility, toxicity, and efficacy of dose-intense accelerated radiation therapy using weekly fractionated stereotactic radiotherapy (FSRT) boost for patients with glioblastoma multiforme (GBM). Methods and Materials: Patients with histologically confirmed GBM with postoperative enhancing tumor plus tumor cavity diameter <60 mm were enrolled. A 50-Gy dose of standard radiation therapy (RT) was given in daily 2-Gy fractions. In addition, patients received four FSRT treatments, once weekly, during Weeks 3 to 6. FSRT dosing of either 5 Gy or 7 Gy per fraction was given for a cumulative dose of 70 or 78 Gy in 29 (25 standard RT + 4 FSRT) treatments over 6 weeks. After the RT course, carmustine (BCNU) at 80 mg/m{sup 2} was given for 3 days, every 8 weeks, for 6 cycles. Results: A total of 76 patients were analyzed. Toxicity included: 3 Grade 4 chemotherapy, 3 acute Grade 4 radiotherapy, and 1 Grade 3 late. The median survival time was 12.5 months. No survival difference is seen when compared with the RTOG historical database. Patients with gross total resection (41%) had a median survival time of 16.6 months vs. 12.0 months for historic controls with gross total resection (p = 0.14). Conclusion: This first, multi-institutional FSRT boost trial for GBM was feasible and well tolerated. There is no significant survival benefit using this dose-intense RT regimen. Subset analysis revealed a trend toward improved outcome for GTR patients suggesting that patients with minimal disease burden may benefit from this form of accelerated RT.},
doi = {10.1016/j.ijrobp.2006.02.042},
url = {https://www.osti.gov/biblio/20850024}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 65,
place = {United States},
year = {Tue Aug 01 00:00:00 EDT 2006},
month = {Tue Aug 01 00:00:00 EDT 2006}
}