Intensity‐modulated radiotherapy (IMRT) in pediatric low‐grade glioma. Issue 14 (30th April 2013)

• Record Type: Journal Article
• Authors: Paulino, Arnold C.; Mazloom, Ali; Terashima, Keita; Su, Jack; Adesina, Adekunle M.; Okcu, M. Faith; Teh, Bin S.; Chintagumpala, Murali
• Is Part Of: Cancer. Volume 119:Issue 14(2013)
• Page Start: 2654
• Page End: 2659
• Publication Date: 2013-04-30
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28118
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr28118-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The objective of this study was to evaluate local control and patterns of failure in pediatric patients with low‐grade glioma (LGG) who received treatment with intensity‐modulated radiation therapy (IMRT).</p> </sec> <sec id="cncr28118-sec-0002" sec-type="section"> <title>METHODS</title> <p>In total, 39 children received IMRT after incomplete resection or disease progression. Three methods of target delineation were used. The first was to delineate the gross tumor volume (GTV) and add a 1‐cm margin to create the clinical target volume (CTV) (Method 1; n = 19). The second was to add a 0.5‐cm margin around the GTV to create the CTV (Method 2; n = 6). The prescribed dose to the GTV was the same as dose to the CTV for both Methods 1 and 2 (median, 50.4 grays [Gy]). The final method was dose painting, in which a GTV was delineated with a second target volume (2TV) created by adding 1 cm to the GTV (Method 3; n = 14). Different doses were prescribed to the GTV (median, 50.4 Gy) and the 2TV (median, 41.4 Gy).</p> </sec> <sec id="cncr28118-sec-0003" sec-type="section"> <title>RESULTS</title> <p>The 8‐year progression‐free and overall survival rates were 78.2% and 93.7%, respectively. Seven failures occurred, all of which were local in the high‐dose (≥95%) region of the IMRT field. On multivariate analysis, age ≤5 years at time of IMRT had a detrimental impact on progression‐free survival.</p> </sec> <sec id="cncr28118-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>IMRT provided local control rates comparable to those provided by 2‐dimensional and 3‐dimensional radiotherapy. Margins ≥1 cm added to the GTV may not be necessary, because excellent local control was achieved by adding a 0.5‐cm margin (Method 2) and by dose painting (Method 3). <bold><italic>Cancer</italic> 2013;119:2654–2659</bold>. © <italic>2013 American Cancer Society</italic>.</p> </sec> </abstract>