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1.
Strahlenther Onkol ; 181(12): 768-73, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16362786

ABSTRACT

PURPOSE: To assess the effect of reirradiation in recurrent WHO grade III astrocytomas. PATIENTS AND METHODS: From January 1995 to July 2003, 40 patients with grade III gliomas were treated with fractionated stereotactic reirradiation at the time point of recurrence. Median size of planning target volume for reirradiation was 56.2 ml (range 25.1-296.2 ml). A median target total dose of 36 Gy (range 20-57.6 Gy) was applied using a median fractionation of 5 x 2 Gy/week with a 6-MeV linear accelerator. RESULTS: Radiotherapy was well tolerated by all patients. No toxicities > CTC grade 2 developed. Median overall survival calculated from the time point of primary diagnosis was 48 months (range 7-180 months). The 5- and 10-year overall survival rates were 49.5% and 24.7%, respectively. From the time point of reirradiation, median survival was 16 months (range 1-98 months). Median progression-free survival from the time point of reirradiation was 8 months (range 1-72 months). No prognosticators for survival or progression-free survival after reirradiation could be identified. CONCLUSION: Fractionated stereotactic radiotherapy is well tolerated and effective in patients with recurrent grade III astrocytomas.


Subject(s)
Astrocytoma/mortality , Astrocytoma/surgery , Brain Neoplasms/mortality , Brain Neoplasms/surgery , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/surgery , Radiosurgery/statistics & numerical data , Adult , Aged , Astrocytoma/classification , Astrocytoma/pathology , Brain Neoplasms/classification , Brain Neoplasms/pathology , Dose Fractionation, Radiation , Female , Germany/epidemiology , Humans , Incidence , Male , Middle Aged , Neoplasm Recurrence, Local/classification , Neoplasm Recurrence, Local/pathology , Prognosis , Risk Assessment/methods , Risk Factors , Severity of Illness Index , Survival Analysis , Survival Rate , Treatment Outcome , World Health Organization
2.
Strahlenther Onkol ; 181(6): 372-7, 2005 Jun.
Article in English | MEDLINE | ID: mdl-15925979

ABSTRACT

BACKGROUND AND PURPOSE: The role of radiochemotherapy in the treatment of primary glioblastoma multiforme is still discussed controversially. To evaluate the feasibility and toxicity of irradiation and concomitant administration of 50 mg/m(2) temozolomide in patients with primary malignant glioma, this phase I/II study was conducted. PATIENTS AND METHODS: 53 Patients with histologically confirmed WHO grade IV malignant glioma were enrolled into the study. All patients were treated with radiation therapy up to a total dose of 60 Gy using conventional fractionation of 5 x 2.0 Gy/week. Temozolomide was administered orally each therapy day at a dose of 50 mg/m(2). RESULTS: Prior to radiochemotherapy, complete resection (n = 14), subtotal resection (n = 22) or a biopsy (n = 17) of the tumor was performed. The median time interval between surgery and radiochemotherapy was 21 days. Treatment-related toxicity was very mild. Acute toxicity > grade 2 was observed in one patient who developed grade 4 hemotoxicity. Minor side effects of chemotherapy included nausea and vomiting. No severe late effects were observed. Median progression-free and overall survival were 8 and 19 months, respectively. The overall survival rate was 72% at 1 and 26% at 2 years. Age and extent of surgery significantly influenced survival. CONCLUSION: The combination of temozolomide plus radiation therapy is feasible and safe in terms of toxicity. Overall survival times were relatively long compared to survival times reported for radiotherapy alone. The application of 50 mg/m(2) of temozolomide can be performed throughout the whole time course without interruption due to side effects and might largely contribute to the prolonged overall survival. Further evaluation is warranted as to which dose of temozolomide is optimal with regard to tumor response and toxicity.


Subject(s)
Antineoplastic Agents, Alkylating/toxicity , Brain Neoplasms/drug therapy , Brain Neoplasms/radiotherapy , Dacarbazine/analogs & derivatives , Glioblastoma/drug therapy , Glioblastoma/radiotherapy , Adult , Aged , Antineoplastic Agents, Alkylating/therapeutic use , Blood Cell Count , Brain Neoplasms/mortality , Brain Neoplasms/surgery , Combined Modality Therapy , Dacarbazine/therapeutic use , Dacarbazine/toxicity , Disease-Free Survival , Female , Glioblastoma/mortality , Glioblastoma/surgery , Humans , Male , Middle Aged , Survival Analysis , Temozolomide , Time Factors
3.
Lung Cancer ; 45 Suppl 1: S85-91, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15261441

ABSTRACT

Pleural mesothelioma is a rare but fatal tumour. Numerous attempts to find effective treatment approaches have, in general, been disappointing. To date, the most promising treatment is surgery, or surgery in combination with radio and chemotherapy as a part of a multidisciplinary approach. Preliminary results from clinical trials evaluating intensity modulated radiotherapy are encouraging. Further randomised trials are proposed.


Subject(s)
Mesothelioma/radiotherapy , Pleural Neoplasms/radiotherapy , Radiotherapy, Conformal/methods , Clinical Trials as Topic , Humans , Imaging, Three-Dimensional , Mesothelioma/surgery , Pleural Neoplasms/surgery , Prognosis , Radiotherapy, Adjuvant
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