摘要
PURPOSE:Weinvestigatethepatternsoffailureinthetreatmentofglioblastoma(GBM)basedonclinicaltargetvolume(CTV)marginsize,dosedeliveredtothesiteofinitialfailure,andtheuseoftemozolomideandintensity-modulatedradiotherapy(IMRT).METHODS:BetweenAugust2000andMay2010,161patientswithGBMweretreatedwithradiotherapywithorwithoutconcurrenttemozolomide.PatientsweretreatedwithCTVexpansionsthatrangedfrom5to20mmusingashrinkingfieldtechnique.PatternsoffailureandtimetoprogressionandoverallsurvivalwerecomparedbasedonCTVmargin,useoftemozolomide,anduseofIMRT.KaplanMeieranalysiswasusedtoestimatesurvivaltimes,andχtestwasusedforcomparisonofcohorts.RESULTS:Forpatientstreatedwith5-,10-,and15-to20-mmCTV,79%,77%,and86%experiencedfailuresinthe60Gyvolume,respectively.Forty-eightpercent,55%,and66%ofpatientswith5-,10-,and15-to20-mmCTVexperiencedfailuresinthe46Gyvolume,respectively.Therewasnostatisticaldifferencebetweenpatientstreatedwith5-,10-,15-to20-mmmarginswithregardto60Gyfailure(P=0.76),46Gyfailure(P=0.51),ormarginalfailure(P=0.73).Eightypercentofpatientsreceivingtemozolomideexperiencedfailuresinthe60Gyvolume.TherewasnoincreasedlikelihoodofmarginalfailuresinpatientsreceivingIMRT(P=0.97).CONCLUSIONS:Moderntreatmenttechniquesincludinguseofconcurrenttemozolmide,limitedCTVmarginsize,andIMRThavenotgreatlychangedthepatternsoffailureofGBM.
出版日期
2013年01月11日（中国期刊网平台首次上网日期，不代表论文的发表时间）
