An analysis of dose-effect relationship in the radiotherapy of malignant gliomas

Walker, Michael D.; Strike, Thomas A.; Sheline, Glenn E.

doi:10.1016/0360-3016(79)90553-4

Cited by 794 publications

(296 citation statements)

References 14 publications

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“…Despite recent developments in surgical techniques and postoperative treatment, the prognosis for patients with a high-grade glioma remains very poor. The median survival has been reported in the range of 12 -15 months for patients with glioblastoma multiforme (GBM) and 36 months for anaplastic astrocytoma (AA) [1][2][3][4]. Conventional treatment of high-grade gliomas includes surgical resection which provides immediate decompression and yields tissue for histopathologic evaluation.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Recurrence Analysis in Newly Diagnosed Glioblastoma Multiforme After Three-Dimensional Conformal Radiation Therapy With Respect to Pre–Radiation Therapy Magnetic Resonance Spectroscopic Findings

Park

Tamai

Lee

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To determine whether the combined MRI and MR spectroscopy imaging (MRSI) prior to radiation therapy (RT) is valuable for RT target definition, and to evaluate the feasibility of replacing the current definition of uniform margins by custom shaped margins based on the information from MRI and MRSI.Methods and Materials-Twenty three GBM patients underwent MRI and MRSI within 4 weeks after surgery but before the initiation of RT and at two month follow-up (FU) intervals thereafter. MRSI data were quantified on the basis of a Choline-to-NAA Index (CNI) as a measure of spectroscopic abnormality. A combined anatomic and metabolic ROI (MRI/S) consisting of T2-weighted hyperintensity, contrast enhancement (CE), resection cavity and CNI2 based on the pre-RT imaging was compared to CNI2 extent and RT dose distribution. The spatial relationship of the pre-RT MRI/S and the RT dose volume was compared to the extent of CE at each FU.Results-Nine patients showed new or increased CE during FU, and 14 patients were either stable or had decreased CE. New or increased areas of CE occurred within CNI2 that was covered by 60 Gy in six patients and within the CNI2 that was not entirely covered by 60 Gy in three patients. New or increased CE resided within the pre-RT MRI/S lesion in 89 % (8/9) of the patients with new or increased CE.Conclusion-These data indicate that the definition of RT target volumes according to the combined morphologic and metabolic abnormality may be sufficient for RT targeting.

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Section: Introductionmentioning

confidence: 99%

Patterns of Recurrence Analysis in Newly Diagnosed Glioblastoma Multiforme After Three-Dimensional Conformal Radiation Therapy With Respect to Pre–Radiation Therapy Magnetic Resonance Spectroscopic Findings

Park

Tamai

Lee

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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“…While radiotherapy is the single most effective treatment after surgical resection (1), the dose that can be safely administered is limited by the tolerance of normal brain tissue. Typical doses for whole or partial brain irradiation can exceed 50 Gy (2, 3), while more spatially constrained procedures (e.g., LINAC-based or gamma knife radiosurgery) can deposit single doses well in excess of 15 Gy to normal tissue at the tumor margins (4).…”

mentioning

confidence: 99%

Rescue of radiation-induced cognitive impairment through cranial transplantation of human embryonic stem cells

Acharya

Christie

Lan

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

114

151

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Cranial irradiation remains a frontline treatment for the control of tumor growth, and individuals surviving such treatments often manifest various degrees of cognitive dysfunction. Radiation-induced depletion of stem/precursor cell pools in the brain, particularly those residing in the neurogenic region of the hippocampus, is believed, in part, to be responsible for these often-unavoidable cognitive deficits. To explore the possibility of ameliorating radiation-induced cognitive impairment, athymic nude rats subjected to head only irradiation (10 Gy) were transplanted 2 days afterward with human embryonic stem cells (hESC) into the hippocampal formation and analyzed for stem cell survival, differentiation, and cognitive function. Animals receiving hESC transplantation exhibited superior performance on a hippocampal-dependent cognitive task 4 months postirradiation, compared to their irradiated surgical counterparts that did not receive hESCs. Significant stem cell survival was found at 1 and 4 months postirradiation, and transplanted cells showed robust migration to the subgranular zone throughout the dentate gyrus, exhibiting signs of neuron morphology within this neurogenic niche. These results demonstrate the capability to ameliorate radiation-induced normal tissue injury using hESCs, and suggest that such strategies may provide useful interventions for reducing the adverse effects of irradiation on cognition.cognition ͉ stem cells ͉ radiotherapy

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“…Admite-se que adultos com astrocitoma grau III ou IV devam ser tratados com telerradioterapia e, eventualmente, com telerradioterapia complementar de reforço ou radioterapia intersticial. Esses procedimentos prolongam a sobrevida de doentes com astrocitomas anaplásicos supratentoriais, segundo estudos retrospectivos 33,38,81,126,162,166,181,182,185,186,200,213,219,224,226,227,228 e prospectivos multicêntricos recentes 223,225 . Nos doentes que se submetem à excisão radical dos astrocitomas malignos, a média de sobrevida é de 4 meses; o tempo de sobrevida aumenta para 9,25 meses naqueles tratados com telerradioterapia após a ressecção 184 .…”

Section: Gliomas Anaplásicosunclassified

“…Walker e cols. 226 e Gutin e cols. 88 indicam a segunda cirurgia quando há agravamento das condições clínicas.…”

Section: Gliomas Anaplásicosunclassified

Untitled

2002

Arq Bras Neurocir

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RESUMO PALAVRAS-CHAVEBraquiterapia. Radioterapia. Tumores encefálicos. ABSTRACT Interstitial radiotherapy for treatment of brain tumors IntroduçãoAs neoplasias do encéfalo estão entre a sexta e oitava causas mais freqüentes de lesões intracranianas dos adultos e a segunda causa mais comum de doença neurológica crônica em pediatria. Os tumores primários do encéfalo correspondem a 2% dos óbitos provocados pelo câncer. São responsáveis por 20% dos tumores malignos diagnosticados antes dos 15 anos de idade e por, aproximadamente, 30% das mortes na sociedade ocidental 118 .Graças à adoção de recursos tecnológicos mais apropriados, à execução de intervenções terapêuticas precoces e à adoção de tratamentos adjuvantes mais adequados, os resultados das terapias para as neoplasias encefálicas tornaram-se mais favoráveis. Entre esses recursos, destacam-se a delineação das lesões com novas técnicas de aquisição de imagem acopladas aos princípios de estereotaxia, a neuronavegação, a eletrofisiologia intra-operatória, a ressonância magnética realizada durante o ato operatório e as conquistas recentes nas áreas de quimioterapia, radioterapia, biologia molecular e genética dos tumores encefálicos.Entretanto, apesar do entusiasmo com a aplicação dos novos conhecimentos em neurooncologia -como a terapia gênica e a imunoterapia -, os procedimentos clássicos fundamentados em cirurgias radicais ou paliativas e em radioterapia e, eventualmente, em quimioterapia são ainda os melhores instrumentos para o tratamento da maioria das lesões neoplásicas primárias ou secundárias do encéfalo. Desses, os procedimentos de radioterapia são considerados um dos mais efetivos, isoladamente ou complementando tratamentos cirúrgicos ou quimioterápicos 22 .

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An analysis of dose-effect relationship in the radiotherapy of malignant gliomas

Cited by 794 publications

References 14 publications

Patterns of Recurrence Analysis in Newly Diagnosed Glioblastoma Multiforme After Three-Dimensional Conformal Radiation Therapy With Respect to Pre–Radiation Therapy Magnetic Resonance Spectroscopic Findings

Patterns of Recurrence Analysis in Newly Diagnosed Glioblastoma Multiforme After Three-Dimensional Conformal Radiation Therapy With Respect to Pre–Radiation Therapy Magnetic Resonance Spectroscopic Findings

Rescue of radiation-induced cognitive impairment through cranial transplantation of human embryonic stem cells

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