During the case of dural lesions, WBRT should really be regarded as. RO 05. A PHASE I DOSE ESCALATION Review OF HYPOFRACTIONATED STEREOTACTIC RADIOTHERAPY IN Blend WITH ZD1839A IN Sufferers WITH RECURRENT MALIGNANT GLIOMAS Changhu Chen,1 Denis Damek,two Laurie E. Gaspar,1 Kevin Lillehei,3 Steve Ojemann,3 David Raben,1 and Brian Kavanagh1, Departments of 1 Radiation Oncology, 2Medical Oncology and 3Neurosurgery, University of Colorado Overall health Sciences Center, Aurora, CO, USA The function of this study was to determine the maximum tolerated dose of hypofractionated stereotactic radiotherapy that may be delivered experienced with ZD1839 to sufferers with recurrent malignant gliomas whose disorder has failed to react to a mixture of surgery, chemotherapy, and radi ation therapy.
Individuals with pathologically diagnosed malignant gliomas that had recurred immediately after surgical procedure, chemotherapy, and radiation therapy were eligible, provided the recur rent tumor was six cm during the largest diameter on MRI T1 weighted imag ing, individuals had ordinary organ perform and blood counts. Patients the full report with a recurrent tumor in the brain stem or in excess of 3 lesions have been excluded. Individuals had been given ZD1839 at 250 mg the moment each day for 7 days in advance of hypo fractionated radiotherapy, which continued throughout and right after radiation for a total duration of one 12 months or till ailment progression. Radiation treatment was delivered making use of the Novalis BrainLab machine in three fractions more than three consecutive days. A removable BrainLab mask was used for immobilization. The target volume was the T1 post contrast enhancing lesion on brain MRI with a two mm margin. The radiation dose was prescribed towards the 80% 90% isodose line that encompassed the target volume. Radiation dose escala tion followed the typical 313 layout, from 18 Gy/6 Gy to 24 Gy/8 Gy 30 Gy/10 Gy to 36 Gy/12 Gy.
Dose limiting toxicity was defined as any grade three acute or delayed toxicity scored by Nationwide Cancer Institute com mon toxicity criteria edition three. Twelve patients were enrolled, with three at every single dose degree. The median age was 46 years. 6 individuals had recurrent anaplastic astrocytoma, as well as the other 6 had recurrent glioblastoma multiforme. All sufferers had undergone radiation therapy to a complete dose of 54 60 Gy. The median time interval from radiation therapy was 13 months. All patients obtained the prescribed dose of hypofractionated stereotactic radiation. The median target volume treated was 36 cc. Using a median follow up time of eight months, there were no dose limiting toxicities. A single patient having a recurrent anaplastic astrocytoma taken care of at 18 Gy skilled seizures 6 months right after radiation therapy and expected salvage surgery.