Faculty Collaboration Database

Semicontinuous low-dose-rate teletherapy for the treatment of recurrent glial brain tumors: final report of a phase I/II study. Int J Radiat Oncol Biol Phys 2012 Feb 01;82(2):765-72

Date

01/18/2011

Pubmed ID

21236600

DOI

10.1016/j.ijrobp.2010.10.057

Scopus ID

2-s2.0-84855841206 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

PURPOSE: Semicontinuous low-dose-rate teletherapy (SLDR) is a novel irradiation strategy that exploits the increased radiosensitivity of glial cells in a narrow range of reduced dose rate. We present the final report of a prospective Phase I/II study testing the feasibility of SLDR for the treatment of recurrent gliomas.

METHODS AND MATERIALS: Patients with previously irradiated recurrent gliomas were enrolled from November 1993 to March 1998. Patients received SLDR, delivered 6 to 8 hours/day at a dose rate of 40 to 50 cGy/hour for a total dose of 30 to 35 Gy given over 12 days using a modified cobalt-60 treatment unit. Acute central nervous system toxicity after SLDR treatment was the primary endpoint. Overall survival was a secondary endpoint.

RESULTS: Twenty patients were enrolled (14 World Health Organization Grade 4 glioma, 5 Grade 2 glioma, 1 ependymoma). No patients developed ≥ Grade 3 central nervous system toxicity at 3 months without radiographic evidence of tumor progression. Overall survival after SLDR was 56% at 6 months, 28% at 12 months, and 17% at 24 months. One patient survived >48 months, and 1 patient survived >60 months after SLDR treatment. Re-resection before SLDR treatment significantly improved 1-year overall survival for all patients and patients with Grade 4 glioma.

CONCLUSION: The delivery of SLDR is feasible in patients with recurrent gliomas and resulted in improved outcomes for patients who underwent re-resection. There were 2 long-term survivors (>48 months). This pilot study supports the notion that reduced dose rate influences the efficacy and tolerance of reirradiation in the treatment of recurrent gliomas.

Author List

Siker ML, Firat SY, Mueller W, Krouwer H, Schultz CJ

Authors

Selim Firat MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Wade M. Mueller MD Professor in the Neurosurgery department at Medical College of Wisconsin
Christopher J. Schultz MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Malika L. Siker MD Associate Dean, Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Brain Neoplasms
Cobalt Radioisotopes
Ependymoma
Feasibility Studies
Glioma
Humans
Middle Aged
Neoplasm Recurrence, Local
Prospective Studies
Radiation Injuries
Radiotherapy
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Salvage Therapy
Young Adult