Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 1;58(3):351-356.
doi: 10.1093/jrr/rrw105.

Radiotherapy using IMRT boosts after hyperbaric oxygen therapy with chemotherapy for glioblastoma

Katsuya Yahara  1 , Takayuki Ohguri  1 , Hiroki Udono  2 , Junkoh Yamamoto  3 , Kyosuke Tomura  1 , Toshihiro Onoda  4 , Hajime Imada  4 , Shigeru Nishizawa  3 , Yukunori Korogi  1
Affiliations

Radiotherapy using IMRT boosts after hyperbaric oxygen therapy with chemotherapy for glioblastoma

Katsuya Yahara et al. J Radiat Res. .

Abstract

The purpose of this study was to evaluate the feasibility and efficacy of radiotherapy (RT) using intensity-modulated radiotherapy (IMRT) boosts after hyperbaric oxygen (HBO) therapy with chemotherapy in patients with glioblastoma. Twenty-four patients with glioblastoma were treated with the combined therapy, which was RT using IMRT boosts after HBO with chemotherapy, and were retrospectively analyzed. The RT protocol was as follows: first, 3D conformal RT [40 Gy/20 fractions (fr)] was delivered to the gross tumor volume (GTV) and the surrounding edema, including an additional 1.5-2.0 cm. The IMRT boost doses were then continuously delivered to the GTV plus 5 mm (28 Gy/8 fr) and the surrounding edema (16 Gy/8 fr). Each IMRT boost session was performed immediately after HBO to achieve radiosensitization. The planned RT dose was completed in all patients, while HBO therapy was terminated in one patient (4%) due to Grade 2 aural pain. The toxicities were mild, no non-hematological toxicity of Grade 3-5 was observed. The 2-year overall survival (OS) and progression-free survival rates in all patients were 46.5% and 35.4%, respectively. The median OS time was 22.1 months. In conclusion, the combined therapy of RT using IMRT boosts after HBO with chemotherapy was a feasible and promising treatment modality for patients with glioblastoma. The results justify further evaluation to clarify the benefits of this therapy.

Keywords: glioblastoma; high-grade glioma; hyperbaric oxygen; intensity-modulated radiotherapy; radiosensitization.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Timing of 3D-CRT, IMRT boost and HBO therapy.
Fig. 2.
Fig. 2.
A magnetic resonance T1-weighted contrast-enhanced image with isodose lines of the IMRT boosts (a) and fluid-attenuated inversion recovery (FLAIR) image sequences (b) in a patient. The red line represents a dose of 28 Gy/8 fr, daily, 3.5 Gy to the CTV3. The yellow line indicates a dose of 16 Gy/8 fr, daily, 2.0 Gy to the CTV2.
Fig. 3.
Fig. 3.
The overall survival and progression-free survival of all patients.
See this image and copyright information in PMC

References

    1. Reddy K, Damek D, Gaspar LE, et al. . Phase II trial of hypofractionated IMRT with temozolomide for patients with newly diagnosed glioblastoma multiforme. Int J Radiat Oncol Biol Phys 2012;84:655–60. - PubMed
    1. Iuchi T, Hatano K, Kodama T, et al. . Phase 2 trial of hypofractionated high-dose intensity modulated radiation therapy with concurrent and adjuvant temozolomide for newly diagnosed glioblastoma. Int J Radiat Oncol Biol Phys 2014;88:793–800. - PubMed
    1. Piroth MD, Pinkawa M, Holy R, et al. . Integrated boost IMRT with FET-PET–adapted local dose escalation in glioblastomas. Results of a prospective phase II study. Strahlenther Onkol 2012;188:334–9. - PubMed
    1. Daruwalla J, Christophi C.. Hyperbaric oxygen therapy for malignancy: a review. World J Surg 2006;30:2112–31. - PubMed
    1. Kohshi K, Beppu T, Tanaka K, et al. . Potential roles of hyperbaric oxygenation in the treatments of brain tumors. Undersea Hyperb Med 2013;40:351–62. - PubMed

Substances