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Title: [F-18]-fluorodeoxyglucose positron emission tomography for targeting radiation dose escalation for patients with glioblastoma multiforme: Clinical outcomes and patterns of failure

Abstract

Purpose: [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging for brain tumors has been shown to identify areas of active disease. Radiation dose escalation in the treatment of glioblastoma multiforme may lead to improved disease control. Based on these premises, we initiated a prospective study of FDG-PET for the treatment planning of radiation dose escalation for the treatment of glioblastoma multiforme. Methods and Materials: Forty patients were enrolled. Patients were treated with standard conformal fractionated radiotherapy with volumes defined by MRI imaging. When patients reached a dose of 45-50.4 Gy, they underwent FDG-PET imaging for boost target delineation, for an additional 20 Gy (2 Gy per fraction) to a total dose of 79.4 Gy (n = 30). Results: The estimated 1-year and 2-year overall survival (OS) for the entire group was 70% and 17%, respectively, with a median overall survival of 70 weeks. The estimated 1-year and 2-year progression-free survival (PFS) was 18% and 3%, respectively, with a median of 24 weeks. No significant improvements in OS or PFS were observed for the study group in comparison to institutional historical controls. Conclusions: Radiation dose escalation to 79.4 Gy based on FDG-PET imaging demonstrated no improvement in OS or PFS. This study establishesmore » the feasibility of integrating PET metabolic imaging into radiotherapy treatment planning.« less

Authors:
 [1];  [2];  [3];  [2];  [3];  [3];  [4];  [4];  [5];  [5]
  1. Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States) and Department of Neurological Surgery, University of Washington Medical Center, Seattle, WA (United States)
  2. Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States)
  3. Department of Nuclear Medicine, University of Washington Medical Center, Seattle, WA (United States)
  4. Department of Neurological Surgery, University of Washington Medical Center, Seattle, WA (United States)
  5. Department of Neurology, University of Washington Medical Center, Seattle, WA (United States)
Publication Date:
OSTI Identifier:
20793360
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 64; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2005.08.013; PII: S0360-3016(05)02380-1; 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; BRAIN; FAILURES; FLUORINE 18; FLUORODEOXYGLUCOSE; GLIOMAS; NMR IMAGING; PATIENTS; PLANNING; POSITRON COMPUTED TOMOGRAPHY; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Douglas, James G, Stelzer, Keith J, Celilo Radiation Therapy, Mid-Columbia Medical Center, The Dalles, OR, Mankoff, David A, Tralins, Kevin S, Krohn, Kenneth A, Muzi, Mark, Silbergeld, Daniel L, Rostomily, Robert C, Scharnhorst, Jeffrey B.S., and Spence, Alexander M. [F-18]-fluorodeoxyglucose positron emission tomography for targeting radiation dose escalation for patients with glioblastoma multiforme: Clinical outcomes and patterns of failure. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Douglas, James G, Stelzer, Keith J, Celilo Radiation Therapy, Mid-Columbia Medical Center, The Dalles, OR, Mankoff, David A, Tralins, Kevin S, Krohn, Kenneth A, Muzi, Mark, Silbergeld, Daniel L, Rostomily, Robert C, Scharnhorst, Jeffrey B.S., & Spence, Alexander M. [F-18]-fluorodeoxyglucose positron emission tomography for targeting radiation dose escalation for patients with glioblastoma multiforme: Clinical outcomes and patterns of failure. United States. https://doi.org/10.1016/J.IJROBP.2005.0
Douglas, James G, Stelzer, Keith J, Celilo Radiation Therapy, Mid-Columbia Medical Center, The Dalles, OR, Mankoff, David A, Tralins, Kevin S, Krohn, Kenneth A, Muzi, Mark, Silbergeld, Daniel L, Rostomily, Robert C, Scharnhorst, Jeffrey B.S., and Spence, Alexander M. 2006. "[F-18]-fluorodeoxyglucose positron emission tomography for targeting radiation dose escalation for patients with glioblastoma multiforme: Clinical outcomes and patterns of failure". United States. https://doi.org/10.1016/J.IJROBP.2005.0.
@article{osti_20793360,
title = {[F-18]-fluorodeoxyglucose positron emission tomography for targeting radiation dose escalation for patients with glioblastoma multiforme: Clinical outcomes and patterns of failure},
author = {Douglas, James G and Stelzer, Keith J and Celilo Radiation Therapy, Mid-Columbia Medical Center, The Dalles, OR and Mankoff, David A and Tralins, Kevin S and Krohn, Kenneth A and Muzi, Mark and Silbergeld, Daniel L and Rostomily, Robert C and Scharnhorst, Jeffrey B.S. and Spence, Alexander M},
abstractNote = {Purpose: [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging for brain tumors has been shown to identify areas of active disease. Radiation dose escalation in the treatment of glioblastoma multiforme may lead to improved disease control. Based on these premises, we initiated a prospective study of FDG-PET for the treatment planning of radiation dose escalation for the treatment of glioblastoma multiforme. Methods and Materials: Forty patients were enrolled. Patients were treated with standard conformal fractionated radiotherapy with volumes defined by MRI imaging. When patients reached a dose of 45-50.4 Gy, they underwent FDG-PET imaging for boost target delineation, for an additional 20 Gy (2 Gy per fraction) to a total dose of 79.4 Gy (n = 30). Results: The estimated 1-year and 2-year overall survival (OS) for the entire group was 70% and 17%, respectively, with a median overall survival of 70 weeks. The estimated 1-year and 2-year progression-free survival (PFS) was 18% and 3%, respectively, with a median of 24 weeks. No significant improvements in OS or PFS were observed for the study group in comparison to institutional historical controls. Conclusions: Radiation dose escalation to 79.4 Gy based on FDG-PET imaging demonstrated no improvement in OS or PFS. This study establishes the feasibility of integrating PET metabolic imaging into radiotherapy treatment planning.},
doi = {10.1016/J.IJROBP.2005.0},
url = {https://www.osti.gov/biblio/20793360}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 64,
place = {United States},
year = {Wed Mar 01 00:00:00 EST 2006},
month = {Wed Mar 01 00:00:00 EST 2006}
}