Возможности протонной терапии при повторном облучении рецидивных глиом

Abstract

Purpose: To define efficiency and safety of use of the active scanning proton beam in reirradiation of recurrent malignant gliomas. Material and methods: Researched group included 26 patients who were treated on a complex of proton therapy Prometeus. 57.7 % of tumors were glioblastoma, 26.9 % – gliomas of GII and 15.4 % GIII gliomas. Proton therapy was carried out with use of the active scanning beam, image-guiding system and use of the individual fixing devices. To all patients PET/CT with 11C-methionine and MRI were carried out, target volume delineation was carried out by results of coregistration of both images. Results: Terms of observation were from 1 to 32 months. The assessment of direct efficiency is carried out at 19 patients in 3 months after completion of treatment. From the group 52.7 % of patients (n = 10) had disease stabilization. At 11.5 % (n = 3) – partial response. Tumor regression volume varied from 50 to 90 %. Progressing of a disease developed in 31.5 % of the considered cases (n = 6). Other 7 patients expect control inspection. 15.4 % (n = 4) patients developed grade 2 radiodermatitis in the field of radiation fields, the remaining 84.6 % (n = 22) had grade 1 radiodermatitis. Of the entire group of patients, only one case of the development of a late radiation complication in the form of radionecrosis is observed at an observation period of 13 months. Conclusion: Preliminary results of a research showed that performing proton therapy by the active scanning beam is the effective method of treatment of patients with the diagnosed recurrent gliomas, allowing to increase life expectancy of patients with maintaining satisfactory general condition.