%0 Journal Article
%T Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme
%A Clifton D Fuller
%A Mehee Choi
%A Britta Forthuber
%A Samuel J Wang
%A Nancy Rajagiriyil
%A Bill J Salter
%A Martin Fuss
%J Radiation Oncology
%D 2007
%I BioMed Central
%R 10.1186/1748-717x-2-26
%X Forty-two patients were treated with IMRT alone (72%) or as a boost (28%) after 3-dimensional conformal radiation therapy (3D-CRT). Thirty-three patients with primary disease and 9 patients with recurrent tumors were included. Thirty-four patients (81%) had surgery, with gross tumor resection in 13 patients (36%); 22 patients (53%) received chemo-radiotherapy. The median total radiation dose for all patients was 60 Gy with a range from 30.6 to 74 Gy. Standard fractions of 1.8 Gy/day to 2.0 Gy/day were utilized.Median survival was 8.7 months, with 37 patients (88%) deceased at last contact. Nonparametric analysis showed no survival difference in IMRT-boost vs. IMRT-only groups.While technically feasible, preliminary results suggest delivering standard radiation doses by IMRT did not improve survival outcomes in this series compared to historical controls. In light of this lack of a survival benefit and the costs associated with use of IMRT, future prospective trials are needed to evaluate non-survival endpoints such as quality of life and functional preservation. Short of such evidence, the use of IMRT for treatment of GBM needs to be carefully rationalized.Malignant gliomas represent the most common primary brain tumors in adults, with approximately 75% of all gliomas classified as high-grade tumors. Within high-grade gliomas, Grade IV gliomas, or glioblastoma multiforme (GBM) exhibit a markedly more grim prognosis, with a median survival prognosis of 8 to 14 months [1-3].The standard treatment of GBM includes surgical extirpation, followed by standard fractionation external beam radiation therapy [4]. When surgical resection is not feasible, radiation therapy is the primary treatment. Within the past decades several studies have explored new treatment regimens for GBM, mainly considering different combinations and doses of chemotherapeutic agents as well as various radiation therapy dose schema and delivery techniques [5-8].Recently, novel radiation approaches affo
%U http://www.ro-journal.com/content/2/1/26