Abstract

Purpose: This study is a retrospective analysis to evaluate the impact of fractionated stereotactic radiotherapy (FSRT) on malignant glioma. Material and Methods: Between June 1996 and May 1998, 37 patients with histology-cally proven WHO grade III or IV glioma (17 Anaplastic astrocytoma, 20 Glioblastoma multiforme) were treated at Taipei Medical University hospital with FSRT. External beam radiotherapy (EBRT) delivered a median dose of 46 Gy which is followed by stereotactic radiotherapy. A frameless fractionated stereotactic radiotherapy was used to boost the tumor bed, using daily fraction of 2.0 -3.0 Gy for 5 to 12 fractions. Non-coplanar arcs (4-8 arcs, median 4 arcs) with 1 to 2 isocenters were mostly used. Survival curves were calculated using the Kaplan-Meier method. Prognostic factors and different treatment variables were tested by univariate and multivariate analysis. Results: Overall median survival was 22 months. One year and 2-year survival rate were 60% and 30% respectively. Follow up imaging study showed tumor reduction greater than 50% in 6 patients (16%), reduction less than 50% or unchanged in 14 patients (38%) and progression in 17 of the 37 patients (46%). On analysis of different prognostic factors, patient's age (<50 years and≧50 years), extent of surgical resection, and tumor volume (<20 ml) were correlated with survival in univariate analysis (p<0.05). Tumor volume and extent of surgical resection remained significant in multivariate analysis. The performance status remained stable for all patients during FSRT and only 5 patients (13%) suffered from treatment related acute toxicity with good medication control. Conclusion: Fractionated stereotactic radiotherapy provides a safe and feasible technique in the primary treatment of malignant gliomas. Although the overall survival and 1 year survival is encouraging, we did not observe a significant dose-effect relationship on overall and progression-free survival. Large series study with long term fallow-up is indicated.
Original languageEnglish
Pages (from-to)147-159
Number of pages13
Journal放射治療與腫瘤學
Volume7
Issue number3
DOIs
Publication statusPublished - 2000

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Glioma
Radiotherapy
Survival
Tumor Burden
Multivariate Analysis
Astrocytoma
Glioblastoma
Disease-Free Survival
Neoplasms
Histology
Therapeutics
Survival Rate

Keywords

  • Stereotactic radiotherapy
  • Glioma
  • survival

Cite this

Fractiona Stereotactic Radiotherapy for Malignant Glioma. / 鍾道生; 邱仲峯(Jeng-Fong Chiou); 高仲瑜; 蔡若婷(Jo-Ting Tsai); 葉啟源; 羅濟慶; 陳品玲(Ping-Ling Chen); 邱文達(Wen-Ta Chiou).

In: 放射治療與腫瘤學, Vol. 7, No. 3, 2000, p. 147-159.

Research output: Contribution to journalArticle

鍾道生 ; 邱仲峯(Jeng-Fong Chiou) ; 高仲瑜 ; 蔡若婷(Jo-Ting Tsai) ; 葉啟源 ; 羅濟慶 ; 陳品玲(Ping-Ling Chen) ; 邱文達(Wen-Ta Chiou). / Fractiona Stereotactic Radiotherapy for Malignant Glioma. In: 放射治療與腫瘤學. 2000 ; Vol. 7, No. 3. pp. 147-159.
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abstract = "Purpose: This study is a retrospective analysis to evaluate the impact of fractionated stereotactic radiotherapy (FSRT) on malignant glioma. Material and Methods: Between June 1996 and May 1998, 37 patients with histology-cally proven WHO grade III or IV glioma (17 Anaplastic astrocytoma, 20 Glioblastoma multiforme) were treated at Taipei Medical University hospital with FSRT. External beam radiotherapy (EBRT) delivered a median dose of 46 Gy which is followed by stereotactic radiotherapy. A frameless fractionated stereotactic radiotherapy was used to boost the tumor bed, using daily fraction of 2.0 -3.0 Gy for 5 to 12 fractions. Non-coplanar arcs (4-8 arcs, median 4 arcs) with 1 to 2 isocenters were mostly used. Survival curves were calculated using the Kaplan-Meier method. Prognostic factors and different treatment variables were tested by univariate and multivariate analysis. Results: Overall median survival was 22 months. One year and 2-year survival rate were 60{\%} and 30{\%} respectively. Follow up imaging study showed tumor reduction greater than 50{\%} in 6 patients (16{\%}), reduction less than 50{\%} or unchanged in 14 patients (38{\%}) and progression in 17 of the 37 patients (46{\%}). On analysis of different prognostic factors, patient's age (<50 years and≧50 years), extent of surgical resection, and tumor volume (<20 ml) were correlated with survival in univariate analysis (p<0.05). Tumor volume and extent of surgical resection remained significant in multivariate analysis. The performance status remained stable for all patients during FSRT and only 5 patients (13{\%}) suffered from treatment related acute toxicity with good medication control. Conclusion: Fractionated stereotactic radiotherapy provides a safe and feasible technique in the primary treatment of malignant gliomas. Although the overall survival and 1 year survival is encouraging, we did not observe a significant dose-effect relationship on overall and progression-free survival. Large series study with long term fallow-up is indicated.",
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author = "道生 鍾 and 邱, {仲峯(Jeng-Fong Chiou)} and 仲瑜 高 and 蔡, {若婷(Jo-Ting Tsai)} and 啟源 葉 and 濟慶 羅 and 陳, {品玲(Ping-Ling Chen)} and 邱, {文達(Wen-Ta Chiou)}",
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TY - JOUR

T1 - Fractiona Stereotactic Radiotherapy for Malignant Glioma

AU - 鍾, 道生

AU - 邱, 仲峯(Jeng-Fong Chiou)

AU - 高, 仲瑜

AU - 蔡, 若婷(Jo-Ting Tsai)

AU - 葉, 啟源

AU - 羅, 濟慶

AU - 陳, 品玲(Ping-Ling Chen)

AU - 邱, 文達(Wen-Ta Chiou)

PY - 2000

Y1 - 2000

N2 - Purpose: This study is a retrospective analysis to evaluate the impact of fractionated stereotactic radiotherapy (FSRT) on malignant glioma. Material and Methods: Between June 1996 and May 1998, 37 patients with histology-cally proven WHO grade III or IV glioma (17 Anaplastic astrocytoma, 20 Glioblastoma multiforme) were treated at Taipei Medical University hospital with FSRT. External beam radiotherapy (EBRT) delivered a median dose of 46 Gy which is followed by stereotactic radiotherapy. A frameless fractionated stereotactic radiotherapy was used to boost the tumor bed, using daily fraction of 2.0 -3.0 Gy for 5 to 12 fractions. Non-coplanar arcs (4-8 arcs, median 4 arcs) with 1 to 2 isocenters were mostly used. Survival curves were calculated using the Kaplan-Meier method. Prognostic factors and different treatment variables were tested by univariate and multivariate analysis. Results: Overall median survival was 22 months. One year and 2-year survival rate were 60% and 30% respectively. Follow up imaging study showed tumor reduction greater than 50% in 6 patients (16%), reduction less than 50% or unchanged in 14 patients (38%) and progression in 17 of the 37 patients (46%). On analysis of different prognostic factors, patient's age (<50 years and≧50 years), extent of surgical resection, and tumor volume (<20 ml) were correlated with survival in univariate analysis (p<0.05). Tumor volume and extent of surgical resection remained significant in multivariate analysis. The performance status remained stable for all patients during FSRT and only 5 patients (13%) suffered from treatment related acute toxicity with good medication control. Conclusion: Fractionated stereotactic radiotherapy provides a safe and feasible technique in the primary treatment of malignant gliomas. Although the overall survival and 1 year survival is encouraging, we did not observe a significant dose-effect relationship on overall and progression-free survival. Large series study with long term fallow-up is indicated.

AB - Purpose: This study is a retrospective analysis to evaluate the impact of fractionated stereotactic radiotherapy (FSRT) on malignant glioma. Material and Methods: Between June 1996 and May 1998, 37 patients with histology-cally proven WHO grade III or IV glioma (17 Anaplastic astrocytoma, 20 Glioblastoma multiforme) were treated at Taipei Medical University hospital with FSRT. External beam radiotherapy (EBRT) delivered a median dose of 46 Gy which is followed by stereotactic radiotherapy. A frameless fractionated stereotactic radiotherapy was used to boost the tumor bed, using daily fraction of 2.0 -3.0 Gy for 5 to 12 fractions. Non-coplanar arcs (4-8 arcs, median 4 arcs) with 1 to 2 isocenters were mostly used. Survival curves were calculated using the Kaplan-Meier method. Prognostic factors and different treatment variables were tested by univariate and multivariate analysis. Results: Overall median survival was 22 months. One year and 2-year survival rate were 60% and 30% respectively. Follow up imaging study showed tumor reduction greater than 50% in 6 patients (16%), reduction less than 50% or unchanged in 14 patients (38%) and progression in 17 of the 37 patients (46%). On analysis of different prognostic factors, patient's age (<50 years and≧50 years), extent of surgical resection, and tumor volume (<20 ml) were correlated with survival in univariate analysis (p<0.05). Tumor volume and extent of surgical resection remained significant in multivariate analysis. The performance status remained stable for all patients during FSRT and only 5 patients (13%) suffered from treatment related acute toxicity with good medication control. Conclusion: Fractionated stereotactic radiotherapy provides a safe and feasible technique in the primary treatment of malignant gliomas. Although the overall survival and 1 year survival is encouraging, we did not observe a significant dose-effect relationship on overall and progression-free survival. Large series study with long term fallow-up is indicated.

KW - Stereotactic radiotherapy

KW - Glioma

KW - survival

KW - 立體定位放射治療

KW - 惡性膠狀瘤

KW - 存活率

U2 - 10.6316/TRO/200007(3)147

DO - 10.6316/TRO/200007(3)147

M3 - Article

VL - 7

SP - 147

EP - 159

JO - 放射治療與腫瘤學

JF - 放射治療與腫瘤學

SN - 1023-988x

IS - 3

ER -