Hisato Nagano MD, Presenter: Nothing to Disclose

Takashi Shuto MD, Abstract Co-Author: Nothing to Disclose

Yuji Yamanaka MD, Abstract Co-Author: Nothing to Disclose

Shigeo Inomori MD, Abstract Co-Author: Nothing to Disclose

Toshiko Ohta MD, Abstract Co-Author: Nothing to Disclose

Tomohiko Okawa MD, PhD, Abstract Co-Author: Nothing to Disclose

Yasuhiko Fujita MD, Abstract Co-Author: Nothing to Disclose

We aimed to investigate whether shortening of the over-all treatment time (OTT) of irradiation improves the survival of patients with glioblastoma multiforme (GBM).

53 patients (26 male, 27 female) with GBM who received 60-62 Gy/30-31 fxs post-operative radiotherapy during 1991-2004 were included. OTT was gradually shortened from conventional 6wks to 4wks and 3wks (from 2002). Patients of 6wks schedule received extended focal irradiation (the edematous area with a 2 cm margin, 40Gy/20fxs/4wks) followed by focal boost (the contrast-enhanced volume with a 2 cm margin, 20Gy/10fxs/2wks). In 4wks schedule, both were delivered concomitantly two or three times a week, using field in Field (f-F) technique. In three-weeks schedule, extended focal dose was reduced to 32Gy/16fxs, and focal boost (28Gy/14fxs) was delivered concomitantly in a day using f-F technique. Those patients who rejected accelerated therapy were treated conventionally. Survival times were calculated by Kaplan-Meier function. Hazard ratios for death were calculated with a Cox model, and were adjusted for OTT, age and performance status (PS).

Average of age was 59.4 y.o. (range; 16- 86). PS at the beginning of irradiation was 0 to 3 (average; 0.6). OTT was ranged 21 to 44 days (average; 30.0). The mean follow-up time from the start day of irradiation was 12.6 months (range; 0.4- 90). 38 patients were dead on disease at the time of analysis. Multivariate analysis was performed significantly (p = 0.008). Hazard ratio of age, PS and OTT was 1.02 (95% CI 1.00-1.05, p = 0.056), 1.75 (95% CI 1.04-2.94, p = 0.034), and 1.06 (95% CI 1.01-1.12, p = 0.024), respectively. Median survival time (MST) of all patients was 12.9 months. 27 patients whose OTT was less than 30 days were survived longer (MST 16.6 months) than the other patients (MST 8.5 months). Log-rank test revealed that the difference was significant (p< 0.03).

OTT was significant variable for survival of patients with GBM, and was recommended not to exceed 29 days or about one month.

Shortening of the over-all treatment time of accelerated irradiation less than 28 days markedly improved the survival of patients with glioblastoma multiforme.

Nagano, H, Shuto, T, Yamanaka, Y, Inomori, S, Ohta, T, Okawa, T, Fujita, Y, Accelerated Field in Field Radiation Therapy for Glioblastoma Multiforme Improved Survival Time.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4427951.html