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@#<b>Objective</b> To evaluate the therapeutic efficacy of radiotherapy with reduced target volume in glioblastoma multiforme patients following surgical treatment, and to provide a basis for the development of postoperative radiotherapy regimens for glioblastoma multiforme. <b>Methods</b> The medical records of 29 patients with glioblastoma multiforme receiving postoperative adjuvant radiochemotherapy with a reduced radiation target were retrospectively reviewed. The gross tumor volume (GTV) included postoperative tumor cavity and residual lesions, and the clinical target volume (CTV) was GTV plus 2.5 cm margin with adaptation according to the affected organs and anatomic structures. GTV and CTV received intensity-modulated radiotherapy with concomitant boost at 60 Gy/30 fractions and 54 Gy/30 fractions, respectively. The progression-free survival (PFS) and site of recurrence were analyzed. <b>Results</b> The patients were followed up until March 2022. Among the 29 patients with glioblastoma multiforme, 3 showed recurrence-free survival of 52, 20, and 19 months, respectively. Among the 26 patients with recurrent glioblastoma multiforme, there were no case with recurrence in CTV, 25 cases with recurrence in GTV (including 3 cases with intracranial dissemination), and one case with intracranial dissemination and without recurrence in GTV. The median PFS was 7 months (4 to 15 months). Among the 3 patients with recurrence in GTV and intracranial dissemination, one showed primary lesion in the right frontal parietal lobe and the metastatic lesion in the right occipital lobe, one primary lesion in the right occipital lobe and multiple metastatic lesions in the cerebellum, and one primary lesion in the left frontal lobe and the metastatic lesion in the right frontal lobe. The PFS was 4 to 5 months for seven patients receiving partial resection, and 6 to 15 months for patients receiving total and subtotal resection. The three recurrence-free survivors all underwent total resection. <b>Conclusion</b> Recurrence in target volume still prevails in patients with glioblastoma multiforme receiving postoperative radiotherapy with reduced target volume, and 60 Gy/30 fractions fail to control the tumor cavity and residual lesions of glioblastoma multiforme.
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Objective To compare the difference of dosimetric results between 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) with 5-field for thoracic middle esophageal carcinoma.Methods Ten patients with thoracic middle esophageal carcinoma were involved in this study.Four treatment plans were designed for each patient,including one 3D-CRT plan and three IMRT plans with 5-field and all evaluation contents were compared.Results There were no significant differences of cord Dmax,total-lung mean dose (Dmean),L-lung Dmean and R-lung V25,V30.Significant differences of heart V30,V40 and Dmean were obtained among the plans,with the lowest of 5IMRT2 (V30:28.67±15.97,V40:13.04±7.28,Dmean:2097.76±718.26) and 5IM RT3(27.39±14.96,13.00±7.32,2096.16±718.85),the highest of 5CRT (43.27±18.69,26.83±19.18,2393.48±896.12) and 5IMRT1 (41.81±17.16,23.08±11.17,2403.77±834.73).There were significant differences of L-lung V5,V10,V15,V20 V25 and V30.All IMRT plans reduce V20,V25 and V30.5IMRT1 did not increase V5 (54.39±7.58) and V10 (44.76±6.30),but reducesd V15 (20.86±5.16),5IMRT2 (V5:70.89±7.95,V10:50.94±8.71,V15:34.20±6.62) and 5IMRT3 (V5:70.26±7.94,V10:49.80±7.62,V15:34.60±5.40)increased V5,V10 and V15.There were also significant differences of R-lung V5.V10,V10,V20 and Dmean.All IMRT plans reduced V20,but increased Vs and V10.5IMRT1 did not increase V15 (23.67±5.73) and Dmean (923.49±182.34); 5IMRT2 did not increases V15 (26.72±±6.79) but increases Dmean (1060.34±205.02); 5IMRT3 increased both V15 (32.40±6.59) and Dmean (1100.54±197.84).Significant differences were found in Dmean,homogeneity index (HI) and conformity index (CI) of PTV,with the best Dmean of 5IMRT1 (6219.80±37.90),the second of 5IMRT3 (6268.91±56.26); the best HI of 5IMRT1 (0.0870±0.0219) and 5IMRT3 (0.0990±0.0219);the best CI of 5IRT2 (0.8682±0.0172) and 5IMRT3 (0.8667±0.0183).Conclusion 5-field IMRT plans have the advantages in the treatment of thoracic middle esophageal carcinoma with better HI,CI of target volume and sparing of lung (V20,V25 and V30) compared to 3D-CRT.5IMRT1 plan has the advantages in reducing low-dose volume (V5,V10,V15 and Dmean) of lung.