Abstract
Purpose: To test the feasibility of salvage radiotherapy using PET-guided helical tomotherapy in patients with progressive malignant pleural mesothelioma (MPM). Patients and Methods: A group of 12 consecutive MPM patients was treated with 56 Gy/25 fractions to the planning target volume (PTV); FDG-PET/CT simulation was always performed to include all positive lymph nodes and MPM infiltrations. Subsequently, a second group of 12 consecutive patients was treated with the same dose to the whole pleura adding a simultaneous integrated boost of 62.5 Gy to the FDG-PET/CT positive areas (BTV). Results: Good dosimetric results were obtained in both groups. No grade 3 (RTOG/EORTC) acute or late toxicities were reported in the first group, while 3 cases of grade 3 late pneumonitis were registered in the second group: the duration of symptoms was 2-10 weeks. Median overall survival was 8 months (1.2-50.5 months) and 20 months (4.3-33.8 months) from the beginning of radiotherapy, for groups I and II, respectively (p = 0.19). A significant impact on local relapse from radiotherapy was seen (median time to local relapse: 8 vs 17 months; 1-year local relapse-free rate: 16% vs 81%, p = 0.003). Conclusions: The results of this pilot study support the planning of a phase III study of combined sequential chemoradiotherapy with dose escalation to BTV in patients not able to undergo resection.
| Original language | English |
|---|---|
| Pages (from-to) | 736-743 |
| Number of pages | 8 |
| Journal | Strahlentherapie und Onkologie |
| Volume | 187 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Nov 2011 |
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Keywords
- Helical tomotherapy
- IGRT
- Malignant pleural mesothelioma
- PET imaging
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Oncology
Cite this
PET-guided dose escalation tomotherapy in malignant pleural mesothelioma. / Fodor, Andrei; Fiorino, Claudio; Dell'Oca, Italo; Broggi, Sara; Pasetti, Marcella; Cattaneo, Giovanni Mauro; Gianolli, Luigi; Calandrino, Riccardo; Di Muzio, Nadia Gisella.
In: Strahlentherapie und Onkologie, Vol. 187, No. 11, 11.2011, p. 736-743.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - PET-guided dose escalation tomotherapy in malignant pleural mesothelioma
AU - Fodor, Andrei
AU - Fiorino, Claudio
AU - Dell'Oca, Italo
AU - Broggi, Sara
AU - Pasetti, Marcella
AU - Cattaneo, Giovanni Mauro
AU - Gianolli, Luigi
AU - Calandrino, Riccardo
AU - Di Muzio, Nadia Gisella
PY - 2011/11
Y1 - 2011/11
N2 - Purpose: To test the feasibility of salvage radiotherapy using PET-guided helical tomotherapy in patients with progressive malignant pleural mesothelioma (MPM). Patients and Methods: A group of 12 consecutive MPM patients was treated with 56 Gy/25 fractions to the planning target volume (PTV); FDG-PET/CT simulation was always performed to include all positive lymph nodes and MPM infiltrations. Subsequently, a second group of 12 consecutive patients was treated with the same dose to the whole pleura adding a simultaneous integrated boost of 62.5 Gy to the FDG-PET/CT positive areas (BTV). Results: Good dosimetric results were obtained in both groups. No grade 3 (RTOG/EORTC) acute or late toxicities were reported in the first group, while 3 cases of grade 3 late pneumonitis were registered in the second group: the duration of symptoms was 2-10 weeks. Median overall survival was 8 months (1.2-50.5 months) and 20 months (4.3-33.8 months) from the beginning of radiotherapy, for groups I and II, respectively (p = 0.19). A significant impact on local relapse from radiotherapy was seen (median time to local relapse: 8 vs 17 months; 1-year local relapse-free rate: 16% vs 81%, p = 0.003). Conclusions: The results of this pilot study support the planning of a phase III study of combined sequential chemoradiotherapy with dose escalation to BTV in patients not able to undergo resection.
AB - Purpose: To test the feasibility of salvage radiotherapy using PET-guided helical tomotherapy in patients with progressive malignant pleural mesothelioma (MPM). Patients and Methods: A group of 12 consecutive MPM patients was treated with 56 Gy/25 fractions to the planning target volume (PTV); FDG-PET/CT simulation was always performed to include all positive lymph nodes and MPM infiltrations. Subsequently, a second group of 12 consecutive patients was treated with the same dose to the whole pleura adding a simultaneous integrated boost of 62.5 Gy to the FDG-PET/CT positive areas (BTV). Results: Good dosimetric results were obtained in both groups. No grade 3 (RTOG/EORTC) acute or late toxicities were reported in the first group, while 3 cases of grade 3 late pneumonitis were registered in the second group: the duration of symptoms was 2-10 weeks. Median overall survival was 8 months (1.2-50.5 months) and 20 months (4.3-33.8 months) from the beginning of radiotherapy, for groups I and II, respectively (p = 0.19). A significant impact on local relapse from radiotherapy was seen (median time to local relapse: 8 vs 17 months; 1-year local relapse-free rate: 16% vs 81%, p = 0.003). Conclusions: The results of this pilot study support the planning of a phase III study of combined sequential chemoradiotherapy with dose escalation to BTV in patients not able to undergo resection.
KW - Helical tomotherapy
KW - IGRT
KW - Malignant pleural mesothelioma
KW - PET imaging
UR - http://www.scopus.com/inward/record.url?scp=84856227197&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84856227197&partnerID=8YFLogxK
U2 - 10.1007/s00066-011-2234-6
DO - 10.1007/s00066-011-2234-6
M3 - Article
C2 - 22037650
AN - SCOPUS:84856227197
VL - 187
SP - 736
EP - 743
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
SN - 0179-7158
IS - 11
ER -