Electronic Resource
Post-Operative Accelerated-Hypofractionated Chemoradiation With Volumetric Modulated Arc Therapy and Simultaneous Integrated Boost in Glioblastoma: A Phase I Study (ISIDE-BT-2)
| العنوان: | Post-Operative Accelerated-Hypofractionated Chemoradiation With Volumetric Modulated Arc Therapy and Simultaneous Integrated Boost in Glioblastoma: A Phase I Study (ISIDE-BT-2) |
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| المؤلفون: | Ferro, Martina, Macchia, Gabriella, Cilla, Savino, Buwenge, M., Re, A., Romano, Maria Concetta, Boccardi, M., Picardi, V., Cammelli, S., Cucci, E., Mignogna, S., Di Lullo, L., Valentini, Vincenzo, Morganti, Alessio Giuseppe, Deodato, Francesco, Ferro M., Macchia G., Cilla S., Romano C., Valentini V. (ORCID:0000-0003-4637-6487), Morganti A. G., Deodato F. (ORCID:0000-0003-1276-5070) |
| بيانات النشر: | Frontiers Media S.A. 2021 |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | Background: Glioblastoma Multiforme (GBM) is the most common primary brain cancer and one of the most lethal tumors. Theoretically, modern radiotherapy (RT) techniques allow dose-escalation due to the reduced irradiation of healthy tissues. This study aimed to define the adjuvant maximum tolerated dose (MTD) using volumetric modulated arc RT with simultaneous integrated boost (VMAT-SIB) plus standard dose temozolomide (TMZ) in GBM. Methods: A Phase I clinical trial was performed in operated GBM patients using VMAT-SIB technique with progressively increased total dose. RT was delivered in 25 fractions (5 weeks) to two planning target volumes (PTVs) defined by adding a 5-mm margin to the clinical target volumes (CTVs). The CTV1 was the tumor bed plus the MRI enhancing residual lesion with 10-mm margin. The CTV2 was the CTV1 plus 20-mm margin. Only PTV1 dose was escalated (planned dose levels: 72.5, 75, 77.5, 80, 82.5, 85 Gy), while PTV2 dose remained unchanged (45 Gy/1.8 Gy). Concurrent and sequential TMZ was prescribed according to the EORTC/NCIC protocol. Dose-limiting toxicities (DLTs) were defined as any G ≥ 3 non-hematological acute toxicity or any G ≥ 4 acute hematological toxicities (RTOG scale) or any G ≥ 2 late toxicities (RTOG-EORTC scale). Results: Thirty-seven patients (M/F: 21/16; median age: 59 years; median follow-up: 12 months) were enrolled and treated as follows: 6 patients (72.5 Gy), 10 patients (75 Gy), 10 patients (77.5 Gy), 9 patients (80 Gy), 2 patients (82.5 Gy), and 0 patients (85 Gy). Eleven patients (29.7%) had G1-2 acute neurological toxicity, while 3 patients (8.1%) showed G ≥ 3 acute neurological toxicities at 77.5 Gy, 80 Gy, and 82.5 Gy levels, respectively. Since two DLTs (G3 neurological: 1 patient and G5 hematological toxicity: 1 patient) were observed at 82.5 Gy level, the trial was closed and the 80 Gy dose-level was defined as the MTD. Two asymptomatic histologically proven radionecrosis were recorded. Conclusions: According to the |
| مصطلحات الفهرس: | adjuvant treatment, glioblastoma multiforme, simultaneous integrated boost, temozolomide, volumetric modulated arc therapy, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, info:eu-repo/semantics/article |
| URL: | info:eu-repo/semantics/altIdentifier/pmid/33692944 info:eu-repo/semantics/altIdentifier/wos/WOS:000626015200001 volume:10 issue:febbraio firstpage:N/A lastpage:N/A issueyear:2021 journal:FRONTIERS IN ONCOLOGY |
| الاتاحة: | Open access content. Open access content |
| ملاحظة: | English |
| Other Numbers: | SYC oai:publicatt.unicatt.it:10807/207146 10.3389/fonc.2020.626400 info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85102386749 1330711343 |
| المصدر المساهم: | UNIV CATTOLICA DEL SACRO CUORE From OAIster®, provided by the OCLC Cooperative. |
| رقم الانضمام: | edsoai.on1330711343 |
| قاعدة البيانات: | OAIster |
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