PET-guided dose escalation tomotherapy in malignant pleural mesothelioma.
Strahlenther Onkol
; 187(11): 736-43, 2011 Nov.
Article
em En
| MEDLINE
| ID: mdl-22037650
ABSTRACT
PURPOSE:
To test the feasibility of salvage radiotherapy using PET-guided helical tomotherapy in patients with progressive malignant pleural mesothelioma (MPM). PATIENTS ANDMETHODS:
A group of 12 consecutive MPM patients was treated with 56 Gy/25 fractions to the planning target volume (PTV); FDG-PET/CT simulation was always performed to include all positive lymph nodes and MPM infiltrations. Subsequently, a second group of 12 consecutive patients was treated with the same dose to the whole pleura adding a simultaneous integrated boost of 62.5 Gy to the FDG-PET/CT positive areas (BTV).RESULTS:
Good dosimetric results were obtained in both groups. No grade 3 (RTOG/EORTC) acute or late toxicities were reported in the first group, while 3 cases of grade 3 late pneumonitis were registered in the second group the duration of symptoms was 2-10 weeks. Median overall survival was 8 months (1.2-50.5 months) and 20 months (4.3-33.8 months) from the beginning of radiotherapy, for groups I and II, respectively (p=0.19). A significant impact on local relapse from radiotherapy was seen (median time to local relapse 8 vs 17 months; 1-year local relapse-free rate 16% vs 81%, p=0.003).CONCLUSIONS:
The results of this pilot study support the planning of a phase III study of combined sequential chemoradiotherapy with dose escalation to BTV in patients not able to undergo resection.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pleurais
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Processamento de Imagem Assistida por Computador
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Radioterapia Assistida por Computador
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Planejamento da Radioterapia Assistida por Computador
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Tomografia Computadorizada por Raios X
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Terapia de Salvação
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Tomografia Computadorizada Espiral
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Tomografia por Emissão de Pósitrons
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Imagem Multimodal
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Radioterapia Guiada por Imagem
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article