Recurrence pattern after [(18)F]Fluoroethyltyrosine-Positron Emission Tomography-guided radiotherapy for high-grade glioma: A prospective study

• Published in: Radiotherapy and oncology 2009-12, Vol.93 (3), p.586-592
• Main Authors: Weber, Damien C, Casanova, Nathalie, Zilli, Thomas, Buchegger, Franz, Rouzaud, Michel, Nouet, Philippe, Vees, Hansjorg, Ratib, Osman, Dipasquale, Giovanna, Miralbell, Raymond
• Format: Article
• Language: English
• Subjects: Adult; Aged; Astrocytoma - diagnostic imaging; Astrocytoma - mortality; Astrocytoma - pathology; Astrocytoma - radiotherapy; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - mortality; Brain Neoplasms - pathology; Brain Neoplasms - radiotherapy; Female; FET-PET; Fluorodeoxyglucose F18; Glioblastoma; Glioblastoma - diagnostic imaging; Glioblastoma - mortality; Glioblastoma - pathology; Glioblastoma - radiotherapy; Hematology, Oncology and Palliative Medicine; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Positron-Emission Tomography; Radiopharmaceuticals; Radiotherapy Planning, Computer-Assisted; Recurrence pattern; Survival Analysis; Survival Rate
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2009.08.043

Abstract Purpose To assess the failure pattern observed after18 F fluoroethyltyrosine (FET) planning after chemo- and radiotherapy (RT) for high-grade glioma. Methods All patients underwent prospectively RT planning using morphological gross tumour volumes (GTVs) and biological tumour volumes (BTVs). The post-treatment recurrence tumour volumes (RTVs) of 10 patients were transferred on their CT planning. First, failure patterns were defined in terms of percentage of RTV located outside the GTV and BTV. Second, the location of the RTV with respect to the delivered dose distribution was assessed using the RTV’s DVHs. Recurrences with >95% of their volume within 95% isodose line were considered as central recurrences. Finally, the relationship between survival and GTV/BTV mismatches was assessed. Results The median percentages of RTV outside the GTV and BTV were 41.8% (range, 10.5–92.4) and 62.8% (range, 34.2–81.1), respectively. The majority of recurrences (90%) were centrally located. Using a composite target volume planning formalism, the degree of GTV and BTV mismatch did not correlate with survivorship. Conclusions The observed failure pattern after FET-PET planning and chemo-RT is primarily central. The target mismatch-survival data suggest that using FET-PET planning may counteract the possibility of BTV-related progression, which may have a detrimental effect on survival.