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Carbon-ion radiotherapy boost with standard dose proton radiation for incomplete-resected high-grade glioma: a phase 1 study.
Qiu, Xianxin; Gao, Jing; Yang, Jing; Hu, Jiyi; Hu, Weixu; Huang, Qingting; Kong, Lin; Lu, Jiade J.
Afiliación
  • Qiu X; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.
  • Gao J; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.
  • Yang J; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Center, Shanghai, China.
  • Hu J; Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.
  • Hu W; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.
  • Huang Q; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.
  • Kong L; Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.
  • Lu JJ; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.
Ann Transl Med ; 10(22): 1193, 2022 Nov.
Article en En | MEDLINE | ID: mdl-36544659
Background: To investigate the maximal tolerated dose (MTD) of a carbon-ion radiotherapy (CIRT) boost prior to standard dose proton radiotherapy (PRT) for newly diagnosed glioblastoma (GBM) and anaplastic astrocytoma (AA) patients with residual lesion after resection. Methods: In total, 18 patients with high-grade glioma (HGG) (16 with GBM and 2 with AA) were enrolled in a prospective 3×3 design phase 1 trial. We investigated four dose-levels of CIRT boost [9 (starting level), 12, 15, and 18 Gy relative biological effectiveness (RBE)] delivered in three equal fractions prior to the standard dose PRT (60 Gy RBE in 30 fractions). Concurrent temozolomide (TMZ) was not provided during the CIRT boost but was initiated on the first day of PRT. Acute and late toxicities were scored based on the Common Terminology Criteria for Adverse Events (CTCAE, v 4.03). Dose-limiting toxicities (DLTs) were defined as radiation-induced severe toxicities (≥ grade 3). Results: With a median follow-up of 17.9 months, no severe (≥ grade 3) acute or late toxicities were observed in patients treated with the first three dose levels (CIRT boost doses of 9, 12, 15 Gy RBE). Severe late toxicity (grade 3 radiation necrosis) was observed in the first patient treated with the 18 Gy RBE CIRT boost level. Therefore, this trial was terminated and the MTD of the induction CIRT boost was determined at 15 Gy RBE in 3 fractions. At the time of this analysis, both patients with AA were alive without disease progression. The progression-free survival (PFS) and overall survival (OS) for GBM at 12 months were 50.6% and 78.6%, respectively. Conclusions: Particle beam radiotherapy consisting of a CIRT boost of 15 Gy RBE (in 3 fractions) following standard dose PRT (60 Gy RBE in 30 fractions), and used in conjunction with TMZ, is safe and potentially effective for patients with HGG.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Transl Med Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: China

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Transl Med Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: China