Department of Radiation Oncology, Tokyo-Edogawa Cancer Centre, Edogawa Hospital, Tokyo, Japan
Department of Radiation Oncology, Tokyo-Edogawa Cancer Centre, Edogawa Hospital, Tokyo, Japan.
Anticancer Res. 2022 Jan;42(1):329-334. doi: 10.21873/anticanres.15489.
BACKGROUND/AIM: This study investigated the feasibility and efficacy of multiparametric magnetic resonance imaging (MRI)-guided dose-escalated hypofractionated intensity-modulated radiation therapy with simultaneous integrated boost (IMRT-SIB) for glioblastoma.
Eighteen patients underwent postoperative IMRT-SIB for glioblastoma using three MRI sequences: double inversion recovery (DIR), diffusion tensor imaging (DTI), and post-gadolinium T1-weighted imaging. Prescribed doses were 60 Gy and 40 Gy in 15 fractions for residual enhancing lesions and surrounding tumor-infiltrating areas, respectively. For surrounding tumor-infiltrating areas, asymmetric margins were set with reference to DTI imaging.
The 1-year overall survival rate was 58.0%, and the 1-year local control rate for the residual enhancing lesions was 76.2%, while that for surrounding tumor-infiltrating areas was 39.4%. One patient (6%) developed grade 2 cerebral radiation necrosis 10 months after IMRT-SIB, but there was no grade 3 or higher adverse event.
Multiparametric MRI-guided dose-escalated IMRT-SIB with DIR and DTI imaging has the potential to improve local control rates without increasing adverse events.
背景/目的：本研究旨在探讨磁共振成像（MRI）引导下多参数剂量递增适形调强放疗同步推量（IMRT-SIB）治疗胶质母细胞瘤的可行性和疗效。
18 名患者术后采用 MRI 的双反转恢复（DIR）序列、弥散张量成像（DTI）和钆后 T1 加权成像（T1WI）三种序列进行 IMRT-SIB 治疗。残留强化病变和周围肿瘤浸润区的预设剂量分别为 60Gy 和 40Gy，15 次分割。对于周围肿瘤浸润区，根据 DTI 图像设定不对称边界。
1 年总生存率为 58.0%，残留强化病变的 1 年局部控制率为 76.2%，而周围肿瘤浸润区的局部控制率为 39.4%。1 例（6%）患者在 IMRT-SIB 后 10 个月发生 2 级脑放射性坏死，但无 3 级或更高级别的不良事件。
MRI 引导下多参数剂量递增 IMRT-SIB 联合 DIR 和 DTI 成像有可能提高局部控制率而不增加不良事件。
