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Title: Evaluation of Peritumoral Edema in the Delineation of Radiotherapy Clinical Target Volumes for Glioblastoma

Abstract

Purpose: To evaluate the spatial relationship between peritumoral edema and recurrence pattern in patients with glioblastoma (GBM). Methods and Materials: Forty-eight primary GBM patients received three-dimensional conformal radiotherapy that did not intentionally include peritumoral edema within the clinical target volume between July 2000 and June 2001. All 48 patients have subsequently recurred, and their original treatment planning parameters were used for this study. New theoretical radiation treatment plans were created for the same 48 patients, based on Radiation Therapy Oncology Group (RTOG) target delineation guidelines that specify inclusion of peritumoral edema. Target volume and recurrent tumor coverage, as well as percent volume of normal brain irradiated, were assessed for both methods of target delineation using dose-volume histograms. Results: A comparison between the location of recurrent tumor and peritumoral edema volumes from all 48 cases failed to show correlation by linear regression modeling (r {sup 2} 0.0007; p = 0.3). For patients with edema >75 cm{sup 3}, the percent volume of brain irradiated to 46 Gy was significantly greater in treatment plans that intentionally included peritumoral edema compared with those that did not (38% vs. 31%; p = 0.003). The pattern of failure was identical between the two sets of plansmore » (40 central, 3 in-field, 3 marginal, and 2 distant recurrence). Conclusion: Clinical target volume delineation based on a 2-cm margin rather than on peritumoral edema did not seem to alter the central pattern of failure for patients with GBM. For patients with peritumoral edema >75 cm{sup 3}, using a constant 2-cm margin resulted in a smaller median percent volume of brain being irradiated to 30 Gy, 46 Gy, and 50 Gy compared with corresponding theoretical RTOG plans that deliberately included peritumoral edema.« less

Authors:
 [1];  [2];  [2];  [2];  [2];  [2];  [2];  [2];  [2];  [2];  [2];  [2]
  1. Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States). E-mail: echang@mdanderson.org
  2. Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)
Publication Date:
OSTI Identifier:
20951625
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 68; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.12.009; PII: S0360-3016(06)03649-2; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; EDEMA; FAILURES; GLIOMAS; IRRADIATION; PATIENTS; PLANNING; RADIATION DOSES; RADIOTHERAPY; RECOMMENDATIONS

Citation Formats

Chang, Eric L., Akyurek, Serap, Avalos, Tedde C, Rebueno, Neal C, Spicer, Chris C, Garcia, John C, Famiglietti, Robin, Allen, Pamela K., Chao, K.S. Clifford, Mahajan, Anita, Woo, Shiao Y., and Maor, Moshe H. Evaluation of Peritumoral Edema in the Delineation of Radiotherapy Clinical Target Volumes for Glioblastoma. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.12.009.
Chang, Eric L., Akyurek, Serap, Avalos, Tedde C, Rebueno, Neal C, Spicer, Chris C, Garcia, John C, Famiglietti, Robin, Allen, Pamela K., Chao, K.S. Clifford, Mahajan, Anita, Woo, Shiao Y., & Maor, Moshe H. Evaluation of Peritumoral Edema in the Delineation of Radiotherapy Clinical Target Volumes for Glioblastoma. United States. doi:10.1016/j.ijrobp.2006.12.009.
Chang, Eric L., Akyurek, Serap, Avalos, Tedde C, Rebueno, Neal C, Spicer, Chris C, Garcia, John C, Famiglietti, Robin, Allen, Pamela K., Chao, K.S. Clifford, Mahajan, Anita, Woo, Shiao Y., and Maor, Moshe H. Tue . "Evaluation of Peritumoral Edema in the Delineation of Radiotherapy Clinical Target Volumes for Glioblastoma". United States. doi:10.1016/j.ijrobp.2006.12.009.
@article{osti_20951625,
title = {Evaluation of Peritumoral Edema in the Delineation of Radiotherapy Clinical Target Volumes for Glioblastoma},
author = {Chang, Eric L. and Akyurek, Serap and Avalos, Tedde C and Rebueno, Neal C and Spicer, Chris C and Garcia, John C and Famiglietti, Robin and Allen, Pamela K. and Chao, K.S. Clifford and Mahajan, Anita and Woo, Shiao Y. and Maor, Moshe H.},
abstractNote = {Purpose: To evaluate the spatial relationship between peritumoral edema and recurrence pattern in patients with glioblastoma (GBM). Methods and Materials: Forty-eight primary GBM patients received three-dimensional conformal radiotherapy that did not intentionally include peritumoral edema within the clinical target volume between July 2000 and June 2001. All 48 patients have subsequently recurred, and their original treatment planning parameters were used for this study. New theoretical radiation treatment plans were created for the same 48 patients, based on Radiation Therapy Oncology Group (RTOG) target delineation guidelines that specify inclusion of peritumoral edema. Target volume and recurrent tumor coverage, as well as percent volume of normal brain irradiated, were assessed for both methods of target delineation using dose-volume histograms. Results: A comparison between the location of recurrent tumor and peritumoral edema volumes from all 48 cases failed to show correlation by linear regression modeling (r {sup 2} 0.0007; p = 0.3). For patients with edema >75 cm{sup 3}, the percent volume of brain irradiated to 46 Gy was significantly greater in treatment plans that intentionally included peritumoral edema compared with those that did not (38% vs. 31%; p = 0.003). The pattern of failure was identical between the two sets of plans (40 central, 3 in-field, 3 marginal, and 2 distant recurrence). Conclusion: Clinical target volume delineation based on a 2-cm margin rather than on peritumoral edema did not seem to alter the central pattern of failure for patients with GBM. For patients with peritumoral edema >75 cm{sup 3}, using a constant 2-cm margin resulted in a smaller median percent volume of brain being irradiated to 30 Gy, 46 Gy, and 50 Gy compared with corresponding theoretical RTOG plans that deliberately included peritumoral edema.},
doi = {10.1016/j.ijrobp.2006.12.009},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 68,
place = {United States},
year = {Tue May 01 00:00:00 EDT 2007},
month = {Tue May 01 00:00:00 EDT 2007}
}