PMID- 22892797
OWN - NLM
STAT- MEDLINE
DCOM- 20140513
LR  - 20220310
IS  - 1437-7772 (Electronic)
IS  - 1341-9625 (Linking)
VI  - 18
IP  - 5
DP  - 2013 Oct
TI  - Accelerated intensity-modulated radiotherapy plus temozolomide in patients with 
      glioblastoma: a phase I dose-escalation study (ISIDE-BT-1).
PG  - 784-91
LID - 10.1007/s10147-012-0462-0 [doi]
AB  - BACKGROUND: We performed a dose-escalation trial to determine the maximum 
      tolerated dose (MTD) of intensity-modulated radiotherapy (IMRT) with standard 
      concurrent and sequential-dose temozolomide (TMZ) in patients with glioblastoma 
      multiforme. METHODS: Histologically proven glioblastoma patients underwent IMRT 
      dose escalation. IMRT was delivered over 5 weeks with the simultaneous integrated 
      boost (SIB) technique to the two planning target volumes (PTVs) defined by adding 
      5-mm margin to the respective clinical target volumes (CTVs). CTV1 was the tumor 
      bed plus the enhancing lesion with 10-mm margin; CTV2 was the area of perifocal 
      edema with 20-mm margin. Only the PTV1 dose was escalated (planned dose 
      escalation: 60, 62.5, 65, 67.5, 70 Gy) while the PTV2 dose remained the same (45 
      Gy). RESULTS: Forty consecutive glioblastoma patients were treated. While no 
      dose-limiting toxicity (DLT) was recorded during the dose escalation up to 
      67.5/2.7 Gy, two out of the first six consecutively enrolled patients on the 
      highest dose level (70/2.8 Gy) experienced a DLT, and therefore a cohort 
      expansion was required. 3/14 patients experienced a DLT on the highest planned 
      dose level, and therefore the MTD was not exceeded. After a median follow-up time 
      of 25 months no grade >2 late neurological toxicity was recorded. CONCLUSIONS: By 
      using a SIB IMRT technique, a radiation dose of 70 Gy in 25 fractions (biological 
      effective dose--BED--of 92.8 Gy) can be delivered with concurrent and sequential 
      standard dose TMZ, without unacceptable acute toxicity in patients with 
      glioblastoma.
FAU - Massaccesi, Mariangela
AU  - Massaccesi M
AD  - Radiotherapy Unit, Department of Oncology, Fondazione di Ricerca e Cura "Giovanni 
      Paolo II", Universita Cattolica del S. Cuore, Largo A. Gemelli 1, 86100, 
      Campobasso, Italy.
FAU - Ferro, Marica
AU  - Ferro M
FAU - Cilla, Savino
AU  - Cilla S
FAU - Balducci, Mario
AU  - Balducci M
FAU - Deodato, Francesco
AU  - Deodato F
FAU - Macchia, Gabriella
AU  - Macchia G
FAU - Valentini, Vincenzo
AU  - Valentini V
FAU - Morganti, Alessio G
AU  - Morganti AG
LA  - eng
PT  - Clinical Trial, Phase I
PT  - Journal Article
DEP - 20120815
PL  - Japan
TA  - Int J Clin Oncol
JT  - International journal of clinical oncology
JID - 9616295
RN  - 7GR28W0FJI (Dacarbazine)
RN  - YF1K15M17Y (Temozolomide)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Brain Neoplasms/drug therapy/pathology/*radiotherapy
MH  - Combined Modality Therapy
MH  - Dacarbazine/administration & dosage/*analogs & derivatives
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Glioblastoma/drug therapy/pathology/*radiotherapy
MH  - Humans
MH  - Male
MH  - Maximum Tolerated Dose
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/drug therapy/pathology/*radiotherapy
MH  - *Radiotherapy, Intensity-Modulated
MH  - Temozolomide
EDAT- 2012/08/16 06:00
MHDA- 2014/05/14 06:00
CRDT- 2012/08/16 06:00
PHST- 2012/02/08 00:00 [received]
PHST- 2012/07/26 00:00 [accepted]
PHST- 2012/08/16 06:00 [entrez]
PHST- 2012/08/16 06:00 [pubmed]
PHST- 2014/05/14 06:00 [medline]
AID - 10.1007/s10147-012-0462-0 [doi]
PST - ppublish
SO  - Int J Clin Oncol. 2013 Oct;18(5):784-91. doi: 10.1007/s10147-012-0462-0. Epub 
      2012 Aug 15.