ABSTRACT
Objective:To compare the efficacy and side effects between simultaneous and sequential integrated boost intensity-modulated radiotherapy after operation for high-grade glioma.Methods:We retrospectively analyzed 142 patients with high-grade glioma who underwent postoperative radiotherapy from January 2010 to December 2017. All patients were divided into the simultaneous and sequential integrated boost intensity-modulated radiotherapy groups. Concurrent temozolomide chemotherapy was delivered during radiotherapy in two groups. The follow-up outcomes were statistically compared between two groups.Results:For the whole group, the median overall survival (OS) was 24 months, the median progression-free survival (PFS) was 17 months, and the median disease-free survival (DFS) was 25 months. In the simultaneous and sequential integrated boost intensity-modulated radiotherapy groups, the median OS were 27.2 and 21.0 months ( P=0.950), the median PFS were 21.2 and 15.0 months ( P=0.21), and the median DFS were 28.0 and 18.0 months ( P=0.171), and the disease control rates were 92.86% and 85.17%( P=0.541), respectively. There was no statistical difference in OS, PFS, DFS, short-term efficacy and side effects between two groups. However, the conformity index in the simultaneous integrated boost intensity-modulated radiotherapy group was better than that in the sequential integrated boost intensity-modulated radiotherapy group ( P=0.032). Conclusions:Postoperative simultaneous and sequential integrated boost intensity-modulated radiotherapy yield no statistical differences in the survival, short-term efficacy and side effects in the treatment of high-grade glioma. However, the conformity index in the simultaneous integrated boost intensity-modulated radiotherapy group is significantly better, which can be recommended for postoperative radiotherapy of high-grade glioma.
ABSTRACT
Radiotherapy is one of the most important treatments of high-grade gliomas (HGG).Currently,there has been no consensus on the standards for the delineation of the gross tumor volume (GTV) based on the simulated computed tomography (CT) scanning and conventional magnetic resonance imaging (MRI).As the radiological technology advances,researchers have found that the application of multimodal MRI including 1 H magnetic resonance spectroscopy (1 H-MRS),blood oxygenation level dependent functional MRI (BOLD-fMRI),diffusion-weighted MRI (DWI) and diffusion tensor imaging (DTI) can evaluate the range of HGG invasion and locate the surrounding vital tissues,thereby serving as a supplement for the delineation of target volume and protection of organs at risk.Moreover,multimodal MRI can be utilized to evaluate the clinical efficacy of radiotherapy,detect the radiation-induced injury and differentiate the progressive disease from pseudoprogression.In this article,the application of multimodal MRI in the postoperative radiotherapy for patients with high-grade glioma was reviewed.