A comparative study on the therapeutic efficacy of conventional radiotherapy and three dimensional conformal radiotherapy for malignant glioma
10.3781/j.issn.1000-7431.2008.12.012
- Author:
Xiao-Shen WANG
1
Author Information
1. Department of Radiation Oncology
- Publication Type:Journal Article
- Keywords:
Glioma;
Magnetic resonance imaging;
Radiotherapy
- From:
Tumor
2008;28(12):1069-1073
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the efficacy of conventional radiotherapy and three dimensional conformal radiotherapy (3D-CRT) for malignant glioma retrospectively. Methods: From January 1997 to May 2007, 152 patients with malignant glioma received postoperative radiotherapy at our hospital. Patients were classified into two groups according to the radiotherapy techniques. Group A (n=85) received conventional whole brain or subtotal brain irradiation at 36.40 Gy followed by a boost of 20 Gy to the tumor bed. Group B (3 D-CRT group, n = 67) were given 50-54 Gy of irradiation in the clinical target volume (CTV) and 60 Gy of irradita-tion in the gross tumor volume (GTV). GTV was defined as the high signal area on T2 weighted FLAIR MRI image, and CTV was defined as GTV plus a 2-cm margin. The fraction dose for both conventional chemotherapy and 3D-CRT was 2.0 Gy/fx, once a day, five times per week. The efficacies of both ratiotherapy were compared and the failure mode was analyzed. Results: The 3-year overall survival rates were 22.9% and 31.9% in group A and group B, respectively (χ2 = 1.01, P = 0.31). Incidence of increased intracra-nial pressure were 47.1% and 31.3% in group A and group B, respectively(χ2 = 3.95, P = 0.04). All the tumor recurrence was detected within the range of GTV and CTV in 45 patients in group B. Conclusion: 3D-CRT reduces the incidence of radiation-induced high intracranial pressure of malignant glioma patients compared with conventional radiotherapy. The irradiation volume including the high signal area on T2 FLAIR MR imaging plus a 2-cm margin is feasible in 3D-CRT.
