Az ismételt frakcionált külso sugárkezelés (reirradiáció) elsodleges központi idegrendszeri daganatok kiújulásának kezelésére: Az elso hazai tapasztalatok

Translated title of the contribution: The possibilities of fractionated external beam reirradiation of relapsed primary brain tumours. The first Hungarian experience

László Mangel, László Sipos, Imre Fedorcsák, Árpád Viola, Jeno Julow, András Bajcsay, György Németh, J. Fodor

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: The practice of image-based three dimensional treatment planning and conformal radio-therapy techniques offer the opportunity to elaborate novel treatment forms, e.g. reirradiation techniques for primary brain tumours. Aim: The authors analysed the effect on survival and toxicity of fractionated external beam reirradiation in brain tumour patients. Methods: At the National Institute of Oncology, between 2002 and 2006, fractionated external beam reirradiation was performed in eleven patients with recurrent primary brain tumour, with total of 50-54 Gy or near total of 34-40 Gy doses. All patients were previously treated with total radiotherapy doses of 50-64 Gy. The intervals between radiotherapy courses were in the range of 7-30 years. All the treatments were carried out with 3D image-based conformal methods, the fractionation was conventional, with 1,8-2,0 Gy daily fractions in all cases. Results: The reirradiation was tolerated well in the material. No grade 3-4 acute toxicity was detected, and serious, grade 3 mental deterioration, not related tumour progression was observed in only one case. In one case reoperation was necessary due to histologically verified radio-necrosis with mass-effect, and we believe that late neurotoxicity caused serious functional inabilities in one case. The median progression free survival was 8 (2-33) months, the median survival was 13 (4,5-33) months. Three of our patients were alive at the end of the study. Conclusions: Based on this experience and current knowledge, in absence of other treatment possibilities, the fractionated external beam reirradiation with near total doses could be a therapeutic choice in case of recurrent primary brain tumours, if having appropriate background. To define the optimal treatment strategy and regimens, further clinical trials should be carried out.

Original languageHungarian
Pages (from-to)1843-1849
Number of pages7
JournalOrvosi Hetilap
Volume148
Issue number39
DOIs
Publication statusPublished - Sep 30 2007

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Brain Neoplasms
Radio
Therapeutics
Radiotherapy
Survival
Three-Dimensional Imaging
Re-Irradiation
Reoperation
Disease-Free Survival
Necrosis
Clinical Trials
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Az ismételt frakcionált külso sugárkezelés (reirradiáció) elsodleges központi idegrendszeri daganatok kiújulásának kezelésére : Az elso hazai tapasztalatok. / Mangel, László; Sipos, László; Fedorcsák, Imre; Viola, Árpád; Julow, Jeno; Bajcsay, András; Németh, György; Fodor, J.

In: Orvosi Hetilap, Vol. 148, No. 39, 30.09.2007, p. 1843-1849.

Research output: Contribution to journalArticle

Mangel, László ; Sipos, László ; Fedorcsák, Imre ; Viola, Árpád ; Julow, Jeno ; Bajcsay, András ; Németh, György ; Fodor, J. / Az ismételt frakcionált külso sugárkezelés (reirradiáció) elsodleges központi idegrendszeri daganatok kiújulásának kezelésére : Az elso hazai tapasztalatok. In: Orvosi Hetilap. 2007 ; Vol. 148, No. 39. pp. 1843-1849.
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abstract = "Introduction: The practice of image-based three dimensional treatment planning and conformal radio-therapy techniques offer the opportunity to elaborate novel treatment forms, e.g. reirradiation techniques for primary brain tumours. Aim: The authors analysed the effect on survival and toxicity of fractionated external beam reirradiation in brain tumour patients. Methods: At the National Institute of Oncology, between 2002 and 2006, fractionated external beam reirradiation was performed in eleven patients with recurrent primary brain tumour, with total of 50-54 Gy or near total of 34-40 Gy doses. All patients were previously treated with total radiotherapy doses of 50-64 Gy. The intervals between radiotherapy courses were in the range of 7-30 years. All the treatments were carried out with 3D image-based conformal methods, the fractionation was conventional, with 1,8-2,0 Gy daily fractions in all cases. Results: The reirradiation was tolerated well in the material. No grade 3-4 acute toxicity was detected, and serious, grade 3 mental deterioration, not related tumour progression was observed in only one case. In one case reoperation was necessary due to histologically verified radio-necrosis with mass-effect, and we believe that late neurotoxicity caused serious functional inabilities in one case. The median progression free survival was 8 (2-33) months, the median survival was 13 (4,5-33) months. Three of our patients were alive at the end of the study. Conclusions: Based on this experience and current knowledge, in absence of other treatment possibilities, the fractionated external beam reirradiation with near total doses could be a therapeutic choice in case of recurrent primary brain tumours, if having appropriate background. To define the optimal treatment strategy and regimens, further clinical trials should be carried out.",
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T2 - Az elso hazai tapasztalatok

AU - Mangel, László

AU - Sipos, László

AU - Fedorcsák, Imre

AU - Viola, Árpád

AU - Julow, Jeno

AU - Bajcsay, András

AU - Németh, György

AU - Fodor, J.

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N2 - Introduction: The practice of image-based three dimensional treatment planning and conformal radio-therapy techniques offer the opportunity to elaborate novel treatment forms, e.g. reirradiation techniques for primary brain tumours. Aim: The authors analysed the effect on survival and toxicity of fractionated external beam reirradiation in brain tumour patients. Methods: At the National Institute of Oncology, between 2002 and 2006, fractionated external beam reirradiation was performed in eleven patients with recurrent primary brain tumour, with total of 50-54 Gy or near total of 34-40 Gy doses. All patients were previously treated with total radiotherapy doses of 50-64 Gy. The intervals between radiotherapy courses were in the range of 7-30 years. All the treatments were carried out with 3D image-based conformal methods, the fractionation was conventional, with 1,8-2,0 Gy daily fractions in all cases. Results: The reirradiation was tolerated well in the material. No grade 3-4 acute toxicity was detected, and serious, grade 3 mental deterioration, not related tumour progression was observed in only one case. In one case reoperation was necessary due to histologically verified radio-necrosis with mass-effect, and we believe that late neurotoxicity caused serious functional inabilities in one case. The median progression free survival was 8 (2-33) months, the median survival was 13 (4,5-33) months. Three of our patients were alive at the end of the study. Conclusions: Based on this experience and current knowledge, in absence of other treatment possibilities, the fractionated external beam reirradiation with near total doses could be a therapeutic choice in case of recurrent primary brain tumours, if having appropriate background. To define the optimal treatment strategy and regimens, further clinical trials should be carried out.

AB - Introduction: The practice of image-based three dimensional treatment planning and conformal radio-therapy techniques offer the opportunity to elaborate novel treatment forms, e.g. reirradiation techniques for primary brain tumours. Aim: The authors analysed the effect on survival and toxicity of fractionated external beam reirradiation in brain tumour patients. Methods: At the National Institute of Oncology, between 2002 and 2006, fractionated external beam reirradiation was performed in eleven patients with recurrent primary brain tumour, with total of 50-54 Gy or near total of 34-40 Gy doses. All patients were previously treated with total radiotherapy doses of 50-64 Gy. The intervals between radiotherapy courses were in the range of 7-30 years. All the treatments were carried out with 3D image-based conformal methods, the fractionation was conventional, with 1,8-2,0 Gy daily fractions in all cases. Results: The reirradiation was tolerated well in the material. No grade 3-4 acute toxicity was detected, and serious, grade 3 mental deterioration, not related tumour progression was observed in only one case. In one case reoperation was necessary due to histologically verified radio-necrosis with mass-effect, and we believe that late neurotoxicity caused serious functional inabilities in one case. The median progression free survival was 8 (2-33) months, the median survival was 13 (4,5-33) months. Three of our patients were alive at the end of the study. Conclusions: Based on this experience and current knowledge, in absence of other treatment possibilities, the fractionated external beam reirradiation with near total doses could be a therapeutic choice in case of recurrent primary brain tumours, if having appropriate background. To define the optimal treatment strategy and regimens, further clinical trials should be carried out.

KW - Conformal fractionated external beam radiotherapy

KW - Glioma

KW - Reirradiation

KW - Tolerance

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