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  • [Clin Cancer Res] Preclinical Assessment of Efficacy of Radiation Dose Painting Based on Intratumoral FDG-PET Uptake

    Maastricht University / Ala Yaromina*

  • 출처
    Clin Cancer Res.
  • 등재일
    2015 Dec 15
  • 저널이슈번호
    21(24):5511-8. doi: 10.1158/1078-0432.CCR-15-0290. Epub 2015 Aug 14.
  • 내용

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    Author information

    Trani D1, Yaromina A2, Dubois L1, Granzier M1, Peeters SG1, Biemans R1, Nalbantov G1, Lieuwes N1, Reniers B3, Troost EE4, Verhaegen F1, Lambin P1.

    1Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands.

    2Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands. ala.yaromina@maastrichtuniversity.nl.

    3Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands. Research group NuTeC, CMK, Hasselt University, Agoralaan Gebouw H, Diepenbeek, Belgium.

    4Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands. Institute of Radiooncology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.

     

    Abstract


    PURPOSE:

    We tested therapeutic efficacy of two dose painting strategies of applying higher radiation dose to tumor subvolumes with high FDG uptake (biologic target volume, BTV): dose escalation and dose redistribution. We also investigated whether tumor response was determined by the highest dose in BTV or the lowest dose in gross tumor volume (GTV).

     

    EXPERIMENTAL DESIGN:

    FDG uptake was evaluated in rat rhabdomyosarcomas prior to irradiation. BTV was defined as 30% of GTV with the highest (BTVhot) or lowest (BTVcold) uptake. To test efficacy of dose escalation, tumor response (time to reach two times starting tumor volume, TGTV2) to Hot Boost irradiation (40% higher dose to BTVhot) was compared with Cold Boost (40% higher dose to BTVcold), while mean dose to GTV remained 12 Gy. To test efficacy of dose redistribution, TGTV2 after Hot Boost was compared with uniform irradiation with the same mean dose (8 or 12 Gy).

     

    RESULTS:

    TGTV2 after 12 Gy delivered heterogeneously (Hot and Cold Boost) or uniformly were not significantly different: 20.2, 19.5, and 20.6 days, respectively. Dose redistribution (Hot Boost) with 8 Gy resulted in faster tumor regrowth as compared with uniform irradiation (13.3 vs. 17.1 days; P = 0.026). Further increase in dose gradient to 60% led to a more pronounced decrease in TGTV2 (10.9 days; P < 0.0001).

     

    CONCLUSIONS:

    Dose escalation effect was independent of FDG uptake in target tumor volume, while dose redistribution was detrimental in this tumor model for dose levels applied here. Our data are consistent with the hypothesis that tumor response depends on the minimum intratumoral dose. Clin Cancer Res; 21(24); 5511-8. ©2015 AACR. 

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