Radiation therapy for the treatment of recurrent glioblastoma: An overview

Cancers

Volumn 4, Issue 1, 2012, Pages 257-280

  Amelio, Dante ^a   Amichetti, Maurizio Amichetti ^a  

^a ATreP Agenzia Provinciale per la Protonterapia   (Italy)

Author keywords

Glioblastoma; Radiation therapy; Recurrence

Indexed keywords

BEVACIZUMAB; PACLITAXEL; TEMOZOLOMIDE; TOPOTECAN;

BRACHYTHERAPY; CANCER CHEMOTHERAPY; CANCER GRADING; CANCER GROWTH; CANCER PALLIATIVE THERAPY; CANCER PATIENT; CANCER RADIOTHERAPY; CANCER RELAPSE; CANCER SURVIVAL; CLINICAL EFFECTIVENESS; DOSIMETRY; EXTERNAL BEAM RADIOTHERAPY; FEASIBILITY STUDY; FRACTIONATED STEREOTACTIC RADIATION THERAPY; GLIOMA; HUMAN; NEUROTOXICITY; NEUTRON CAPTURE THERAPY; OVERALL SURVIVAL; PATIENT SAFETY; PROGNOSIS; RADIATION DOSE; RADIATION HAZARD; RADIATION INJURY; RADIOIMMUNOTHERAPY; RECURRENT CANCER; RETREATMENT; RETROSPECTIVE STUDY; REVIEW; SALVAGE THERAPY; STEREOTACTIC RADIOSURGERY; SURVIVAL TIME; THREE DIMENSIONAL IMAGING;

EID: 84859040014     PISSN: None     EISSN: 20726694     Source Type: Journal    
DOI: 10.3390/cancers4010257     Document Type: Review

References (84)

1. Wen, P.Y.; Kesari, S. Malignant gliomas in adults. N. Engl. J. Med. 2008, 359, 492-507.
2. Stupp, R.; Hegi, M.E.; Gilbert, M.R.; Chakravarti, A. Chemoradiotherapy in malignant glioma: Standard of care and future directions. J. Clin. Oncol. 2007, 25, 4127-4136.
3. Stupp, R.; Hegi, M.E.; Mason, W.P.; van den Bent, M.J.; Taphoorn, M.J.; Janzer, R.C.; Ludwin, S.K.; Allgeier, A.; Fisher, B.; Belanger, K.; et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-Year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009, 10, 459-466.
4. Minniti, G.; Amelio, D.; Amichetti, M.; Salvati, M.; Muni, R.; Bozzao, A.; Lanzetta, G.; Scarpino, S.; Arcella, A.; Enrici, R.M. Patterns of failure and comparison of different target volume delineations in patients with glioblastoma treated with conformal radiotherapy plus concomitant and adjuvant temozolomide. Radiother. Oncol. 2010, 97, 377-381.
5. Barbagallo, G.M.; Jenkinson, M.D.; Brodbelt, A.R. "Recurrent" glioblastoma multiforme, when should we reoperate? Br. J. Neurosurg. 2008, 22, 452-455.
6. Soults, C.B.; Canute, G.S.; Ryken, T.C. Evidence-based review of the role of reoperation in the management of malignant glioma. Neurosurg. Focus 1998, 4, e11.
7. Guyotat, J.; Signorelli, F.; Frappaz, D.; Madarassy, G.; Ricci, A.C.; Bret, P. Is reoperation for recurrence of glioblastoma justified? Oncol. Rep. 2000, 7, 899-904.
8. Harsh, G.R., IV; Levin, V.A.; Gutin, P.H.; Seager, M.; Silver, P.; Wilson, C.B. Reoperation for recurrent glioblastoma and anaplastic astrocytoma. Neurosurgery 1987, 21, 615-621.
9. Ammirati, M., Galicich, J.H., Arbit, E., Liao, Y. Reoperation in the treatment of recurrent intracranial malignant gliomas. Neurosurgery 1987, 21, 607-614.
10. Wick, W.; Platten, M.; Weller, M. New (alternative) temozolomide regimens for the treatment of gliomas. Neurooncology 2009, 11, 69-79.
11. Wick, W.; Weller, M.; Weiler, M.; Batchelor, T.; Yung, W.K.A.; Platten, M. Pathway inhibition: Emerging molecular targets for treating glioblastoma. Neurooncology 2011, 13, 566-579.
12. Matsusue, E.; Fink, J.R.; Rockhill, J.K.; Ogawa, T.; Maravilla, K.R. Distinction between glioma progression and post-radiation change by combined physiologic MR imaging. Neuroradiology 2010, 52, 297-306.
13. Fraass, B.A.; Moran, J.M. Quality, technology and outcomes: Evolution and evaluation of new treatments and or new technology. Semin. Radiat. Oncol. 2012, 22, 3-10.
14. Ang, K.K.; Jiang, J.L.; Guttenberger, R.; Thames, H.D.; Stephens, L.C.; Smith, C.D.; Feng, Y. Impact of spinal cord repair kinetics on the practice of altereted fractionation schedules. Radiother. Oncol. 1992, 25, 287-294.
15. Mayer, R.; Sminia, P. Reirradiation tolerance of the human brain. Int. J. Radiat. Oncol. Biol. Phys. 2008, 70, 1350-1360.
16. Nieder, C.; Grosu, A.L.; Molss, M. A comparison of treatment results for recurrent malignant gliomas. Cancer Treat. Rev. 2000, 26, 397-409.
17. Overgaard, J.; Horsman, M.R. Modification of hypoxia-induced radioresistence in tumors by the use of oxygen and sensitizers. Semin. Radiat. Oncol. 1996; 6, 10-21.
18. Whiters, H.R. Cell cycle redistribution as factor in multifractionation irradiation. Radiology 1975, 114, 199-202.
19. Larson, D.A.; Flickinger, J.C.; Loeffler, J.S. Radiobilogy of radiosurgery. Int. J. Radiat. Oncol. Biol. Phys. 1993; 25, 557-561.
20. Nieder, C.; Nestle, U.; Ketter, R.; Kolles, H.; Gentner, S.J.; Steudel, W.I.; Schnabel, K. Hyperfractionated and accelerated-hyperfractionated radiotherapy for glioblastoma multiforme. Radiat. Oncol. Investig. 1999, 7, 36-41.
21. Veninga, T.; Langendijk, H.A.; Slotman, B.J.; Rutten, E.H.; van der Kogel, A.J.; Prick, M.J.; Keyser, A.; van der Maazen, R.W. Reirradiation of primary brain tumours: Survival, clinical response and prognostic factors. Radiother. Oncol. 2001, 59, 127-137.
22. Henke, G.; Paulsen, F.; Steinbach, J.P.; Ganswindt, U.; Isijanov, H.; Kortmann, R.D.; Bamberg, M.; Belka, C. Hypofractionated reirradiation for recurrent malignant glioma. Strahlenther. Onkol. 2009, 185, 113-119.
23. Leksell, L. The stereotactic method and radiosurgery of the brain. Acta Chir. Scand. 1951, 102, 316-319.
24. Lederman, G.; Wronski, M.; Arbit, E.; Odaimi, M.; Wertheim, S.; Lombardi, E.; Wrzolek, M. Treatment of recurrent glioblastoma multiforme using fractionated stereotactic radiosurgery and concurrent paclitaxel. Am. J. Clin. Oncol. 2000, 23, 155-159.
25. Hudes, R.S.; Corn, B.W.; Werner-Wasik, M.; Andrews, D.; Rosenstock, J.; Thoron, L.; Downes, B.; Curran, W.J., Jr. A phase I dose escalation study of hypofractionated stereotactic radiotherapy as salvage therapy for persistent or recurrent malignant glioma. Int. J. Radiat. Oncol. Biol. Phys. 1999, 43, 293-298.
26. Selch, M.T.; DeSalles, A.A.F.; Solberg, T.D.; Wallace, R.E.; Do, T.M.; Ford, J.; Cabatan-Awang, C.; Withers, H.R. Hypofractionated stereotactic radiotherapy for recurrent malignant gliomas. J. Radiosurg. 2000, 3, 3-12.
27. Combs, S.E.; Gutwein, S.; Thilmann, D.; Huber, P.; Debus, J.; Schulz-Ertner, D. Stereotactically guided fractionated re-irradiation in recurrent glioblastoma multiforme. J. Neurooncol. 2005, 74, 167-171.
28. Vordermark, D.; Kolbl, O.; Ruprecht, K.; Vince, G.H.; Bratengeier, K.; Flentje, M.; Vince, G.H.; Bratengeier, K. Hypofractionated stereotactic re-irradiation: Treatment option in recurrent malignant glioma. BMC Cancer 2005, 5, 55.
29. Wurm, R.E.; Kuczer, D.A.; Schlenger, L.; Matniani, G.; Scheffler, D.; Cosgrove, V.P.; Ahlswede, J.; Woiciechowski, C.; Budach, V. Hypofractionated stereotactic radiosurgery combined with topotecan in recurrent malignant glioma. Int. J. Radiat. Oncol. Biol. Phys. 2006, 66, S26-S32.
30. Kohshi, K.; Yamamoto, H.; Nakahara, A.; Katoh, T.; Takagi, M. Fractionated stereotactic radiotherapy using gamma unit after hyperbaric oxygenation on recurrent high-grade gliomas. J. Neurooncol. 2007, 82, 297-303.
31. Combs, S.E.; Bischof, M.; Welzel, T.; Hof, H.; Oertel, S.; Debus, J.; Schulz-Ertner, D. Radiochemotherapy with temozolomide as reirradiation using high precision fractionated stereotactic radiotherapy (FSRT) in patients with recurrent gliomas. J. Neurooncol. 2008, 89, 205-210.
32. Fokas, E.; Wacker, U.; Gross, M.W.; Henzel, M.; Encheva, E.; Engenhart-Cabillic, R. Hypofractionated stereotactic reirradiation of recurrent glioblastomas: A beneficial treatment option after high-dose radiotherapy? Strahlenther. Onkol. 2009, 185, 235-240.
33. Patel, M.; Siddiqui, F.; Jin, J.Y.; Mikkelsen, T.; Rosenblum, M.; Movsas, B.; Ryu, S. Salvage reirradiation for recurrent glioblastoma with radiosurgery: Radiographic response and improved survival. J. Neurooncol. 2009, 92, 185-191.
34. Gutin, P.H.; Iwamoto, F.M.; Beal, K.; Mohile, N.A.; Karimi, S.; Hou, B.L.; Lymberis, S.; Yamada, Y.; Chang, J.; Abrey, L. Safety and efficacy of bevacizumab with hypofractionated stereotactic irradiation for recurrent malignant gliomas. Int. J. Radiat. Oncol. Biol. Phys. 2008, 75, 156-163.
35. Villavicencio, A.T.; Burneikiene, S. Romanelli, P.; Fariselli, L.; McNeely, L.; Lipani, J.D.; Chang, S.D.; Nelson, E.L.; McIntyre, M.; Broggi, G.; et al. Survival following stereotactic radiosurgery for newly diagnosed and recurrent glioblastoma multiforme: A multicenter experience. Neurosurg. Rev. 2009, 32, 417-424.
36. Fogh, S.E.; Andrews, D.W.; Glass, J.; Curran, W.; Glass, C.; Champ, C.; Evans, J.J.; Hyslop, T.; Pequignot, E.; Downes, B.; et al. Hypofractionated stereotactic radiation therapy: An effective therapy for recurrent high-grade gliomas. J. Clin. Oncol. 2010, 28, 3048-3053.
37. Minniti, G.; Armosini, V.; Salvati, M.; Lanzetta, G.; Caporello, P.; Mei, M.; Osti, M.F.; Maurizi, R.E. Fractionated stereotactic reirradiation and concurrent temozolomide in patients with recurrent glioblastoma. J. Neurooncol. 2011, 103, 683-691.
38. Maier-Hauff, K.; Ulrich, F.; Nestler, D.; Niehoff, H.; Wust, P.; Thiesen, B.; Orawa, H.; Budach, V.; Jordan, A. Efficacy and safety of intratumoral thermotherapy using magnetic iron-oxide nanoparticles combined with external beam radiotherapy on patients with recurrent glioblastoma multiforme. J. Neurooncol. 2011, 103, 317-324.
39. Luxton, G.; Petrovich, Z.; Jozsef, G.; Nedzi, L.A.; Apuzzo, M.L. Stereotactic radiosurgery: Principles and comparison of treatment methods. Neurosurgery 1993, 32, 241-259.
40. Loeffler, J.S.; Kooy, H.W.; Wen, P.Y.; Fine, H.A.; Cheng, C.W.; Mannarino, E.G.; Tsai, J.S.; Alexander, E. The treatment of recurrent brain metastasis with stereotactic radiosurgery. J. Clin. Oncol. 1990, 8, 576-582.
41. Gevaert, T.; Verellen, D.; Tournel, K.; Linthout, N.; Bral, S.; Engels, B.; Collen, C.; Depuydt, T.; Duchateau, M.; Reynders, T.; et al. Setup accuracy of the Novalis ExacTrac 6DOF system for frameless radiosurgery. Int. J. Radiat. Oncol. Biol. 2011, in press.
42. Muacevic, A.; Kufeld, M.; Wowra, B.; Kreth, F.W.; Tonn, J.C. Feasibility, safety, and outcome of frameless image-guided robotic radiosurgery for brain metastases. J. Neurooncol. 2010, 97, 267-274.
43. Shrieve, D.C.; Alexander, E., III; Wen, P.Y.; Fine, H.A.; Kooy, H.M.; Black, P.M.; Loeffler, J.S. Comparison of stereotactic radiosurgery and brachytherapy in the treatment of recurrent glioblastoma multiforme. Neurosurgery 1995, 36, 275-284.
44. Larson, D.A.; Gutin, P.H.; McDermott, M.; Lamborn, K.; Sneed, P.K.; Wara, W.M.; Flickinger, J.; Kondziolka, D.; Lunsford, L.D.; Hudgins, W.R.; et al. Gamma knife for glioma: Selection factors and survival. Int. J. Radiat. Oncol. Biol. Phys. 1996, 36, 1045-1053.
45. Kondziolka, D.; Flickinger, J.; Jonh, C.; Bisonette, D.J.; Bozik, M.; Lunsford, L.D. Survival benefit of stereotactic radiosurgery for patients with malignant glial neoplasm. Neurosurgery 1997, 41, 776-785.
46. Park, J.L.; Suh, J.H.; Barnett, G.H.; Reddy, C.A.; Peereboom, D.M.; Stevens, G.H.J.; Cohen, B.H. Survival after stereotactic radiosurgery for recurrent glioblastoma multiforme. J. Radiosurg. 2000, 3, 169-175.
47. Larson, D.A.; Prodos, M.; Lamborn, K.R.; Smith, V.; Sneed, P.K.; Chang, S.; Nicholas, K.M.; Wara, W.M.; Devriendt, D.; Kunvar, S.; et al. Phase II study of high central dose gamma knife radiosurgery and marimastat in patients with recurrent malignant glioma. Int. J. Radiat. Oncol. Biol. Phys. 2002, 54, 1397-1304.
48. Combs, S.E.; Widmer, V.; Thilmann, C.; Holger, H.; Debus, J.; Schulz-Ertner, D. Stereotactic radiosurgery (SRS). Treatment option for recurrent glioblastoma multiforme (GBM). Cancer 2005, 104, 2168-2173.
49. Hsieh, P.C.; Chandler, J.P.; Bhangoo, S.; Panagiotopoulos, K.; Kalapurakal, J.A.; Maymont, M.H.; Cozzens, J.W.; Levy, R.M.; Salehi, S. Adjuvant gamma knife stereotactic radiosurgery at the time of tumor progression potentially improves survival for patients with glioblastoma multiforme. Neurosurgery 2005, 57, 684-691.
50. Mahajan, A.; McCutcheon, I.E.; Suki, D.; Chang, E.L.; Hassenbach, S.J.; Weinberg, J.S.; Shiu, A.; Maor, M.H.; Woo, S.Y. Case-control study of stereotactic radiosurgery for recurrent glioblastoma multiforme. J. Neurosurg. 2005, 103, 210-217.
51. Kong, D.S.; Lee, J.I.; Park, K.; Kim, J.H.; Lim, D.H.; Nam, D.H. Efficacy of stereotactic radiosurgery as a salvage treatment for recurrent malignant gliomas. Cancer 2008, 112, 2046-2051.
52. Biswas, T.; Okunieff, P.; Schell, M.C.; Smudzin, T.; Pilcher, W.H.; Bakos, R.S.; Vates, G.E.; Walter, K.A.; Wensel, A.; Korones, D.N.; et al. Stereotactic radiosurgery for glioblastoma: Retrospective analysis. Radiat. Oncol. 2009, 4, 11.
53. Maranzano, E.; Anselmo, P.; Casale, M.; Trippa, F.; Carletti, S.; Principi, M.; Loreti, F.; Italiani, M.; Caserta, C.; Giorgi, C. Treatment of recurrent glioblastoma with stereotactic radiotherapy: Long-term results of a mono-institutional trial. Tumori 2011, 97, 56-61.
54. Liu, B.L.; Cheng, J.X.; Zhang, X.; Zang, W. Controversies concerning the application of brachytherapy in central nervous system tumors. J. Cancer Res. Clin. Oncol. 2010, 136, 173-185.
55. Scharfen, C.O.; Sneed, P.K.; Wara, W.M.; Larson, D.A.; Phillips, T.L.; Prados, M.D.; Weaver, K.A.; Malec, M.M.; Acord, P.; Lamborn, K.R.; et al. High activity iodine-125 interstitial implant for gliomas. Int. J. Radiat. Oncol. Biol. Phys. 1992, 24, 583-591.
56. Simon, J.M.; Cornu, P.; Boisserie, G.; Hasboun, D.; Tep, B.; Hardiman, C.; Valery, C.A.; Delattre, J.Y.; Dormont, D.; Baillet, F.; et al. Brachytherapy of glioblastoma recurring in previously irradiated territory: Predictive value of tumor volume. Int. J. Radiat. Oncol. Biol. Phys. 2002, 53, 67-74.
57. Tselis, N.; Kolotas, C.; Birn, G.; Röddiger, S.; Filipowicz, I.; Kontova, M.; Fountzilas, G.; Selviaridis, P.; Baltas, D.; Heyd, R.; et al. CT-guided interstial HDR brachytherapy for recurrent glioblastoma multiforme. Long-term results. Strahlenther. Onkol. 2007, 183, 563-570.
58. Larson, G.L.; Wilbanks, J.H.; Dennis, W.S.; Permenter, W.D.; Easley, J.D. Interstial radiogold implantation for the treatment of recurrent high-grade gliomas. Cancer 1990, 66, 27-29.
59. 125I brachytherapy for recurrent high-grade astrocytomas. Int. J. Radiat. Oncol. Biol. Phys. 1996, 35, 541-547.
60. 125iodine implants for recurrent malignant gliomas. Int. J. Radiat. Oncol. Biol. Phys. 1999, 43, 977-982.
61. Patel, S.; Breneman, J.C.; Warnick, R.E.; Albright, R.E.; Tobler, W.D.; van Loveren, H.R.; Tew, J.M. Permanent iodine-125 interstial implants for the treatment of recurrent glioblastoma multiforme. Neurosurgery 2000, 46, 1123-1130.
62. Larson, D.A.; Suplica, J.M.; Chang, S.M.; Lamborn, K.R.; McDermott, M.W.; Sneed, P.K.; Prados, M.D.; Wara, W.M.; Nicholas, M.K.; Berger, M.S. Permanent iodine 125 brachytherapy in patients with progressive or recurrent glioblastoma multiforme. Neurooncology 2004, 6, 119-126.
63. Darakchiev, B.J.; Albright, R.E.; Breneman, J.C.; Warnick, R. Safety and efficacy of permanent iodine-125 implants and carmustine wafers in patients with recurrent glioblastoma multiforme. J. Neurosurg. 2008, 108, 236-242.
64. 125I radiation source (GliaSite radiation therapy system) for treatment of recurrent malignant glioma: Multicenter safety and feasibility trial. J. Neurosurg. 2003, 99, 297-303.
65. Chan, T.A.; Weingart, J.D.; Parisi, M.; Hughes, M.A.; Olivi, A.; Borzillary, S.; Alahakone, D.; Detorie, N.A.; Wharam, M.D.; Kleinberg, L. Treatment of recurrent glioblastoma multiforme with gliasite brachytherapy. Int. J. Radiat. Oncol. Biol. Phys. 2005, 62, 1133-1139.
66. Gabayan, A.J.; Green, S.B.; Sanan, A.; Jenrette, J.; Schultz, C.; Papagikos, M.; Tatter, S.P.; Patel, A.; Amin, P.; Lustig, R.; et al. Gliasite brachytherapy for treatment of recurrent malignant gliomas: A retrospective multi-institutional analysis. Neurosurgery 2006, 58, 701-708.
67. Boiardi, A.; Bartolomei, M.; Silvani, A.; Eoli, M.; Salmaggi, A.; Lamperti, E.; Milanesi, I.; Botturi, A.; Rocca, P.; Bodei, L.; et al. Intratumoral delivery of mitoxantrone in association with 90-Y radioimmunotherapy (RIT) in recurrent glioblastoma. J. Neurooncol. 2005, 72, 125-131.
68. Mamelak, A.N.; Rosenfeld, S.; Bucholz, R.; Raubitschek, A.; Nabors, L.B.; Fiveash, J.B.; Shen, S.; Khazaeli, M.B.; Colcher, D.; Liu, A.; et al. Phase I single-dose study of intracavitary-administered iodine-131-TM-601 in adults with recurrent high-grade glioma. J. Clin. Oncol. 2006, 24, 3644-3650.
69. Kankaanranta, L.; Seppala, T.; Koivunoro, H.; Valimaki, P.; Beule, A.; Collan, J.; Kortesniemi, M.; Uusi-Simola, J.; Kotiluoto, P.; Auterinen, I.; et al. L-Boronophenylalanine-mediated boron neutron capture therapy for malignant glioma progressing after external beam radiation therapy: A phase I study. Int. J. Radiat. Oncol. Biol. Phys. 2011, 80, 369-376.
70. Pellettieri, L.; H-Stenstam, B.; Rezaei, A.; Giusti, V.; Skold, K. An investigation of boron neutron capture therapy for recurrent glioblastoma multiforme. Acta Neurol. Scand. 2008, 117, 191-197.
71. Mandl, E.S.; Dirven, C.M.; Buis, D.R.; Postma, T.J.; Vandertop, W.P. Repeated surgery for glioblastoma multiforme: Only in combination with other salvage therapy. Surg. Neurol. 2008, 69, 506-509.
72. Dirks, P.; Bernstein, M.; Muller, P.J.; Tucker, W.S. The value of reoperation for recurrent glioblastoma. Can. J. Surg. 1993, 36, 271-275.
73. Barker, F.G., II; Chang, S.M.; Gutin, P.H.; Malec, M.K.; McDermott, M.W.; Prados, M.D.; Wilson, C.B. Survival and functional status after resection of recurrent glioblastoma multiforme. Neurosurgery 1998, 42, 709-720.
74. Niyazi, M.; Siefert, A.; Schwarz, S.B.; Ganzwindt, U.; Kreth, F.W.; Tonn, J.C.; Belka, C. Therapeutic options for recurrent malignant glioma. Radiother. Oncol. 2011, 98, 1-14.
75. Brainin, M.; Barnes, M.; Baron, J.C.; Gilhus, N.E.; Hughes, R.; Selmaj, K.; Waldemar, G. Guidance for the preparation of neurological management guidelines by EFNS scientific task forces-Revised recommendations 2004. Eur. J. Neurol. 2004, 11, 577-581.
76. Cochrane Handbook for Systematic Reviews of Interventions, Version 5.0.2. Available online: http://www.cochrane-handbook.org (accessed on 1 March 2012).
77. Lamborn, K.R.; Alfred Yung, W.K.; Chang, S.M.; Wen, P.Y.; Cloughesy, T.F.; DeAngelis, L.M.; Robins, H.I.; Lieberman, F.S.; Fine, H.A.; Fink, K.L.; et al. Progression-free survival: An important end point in evaluating therapy for recurrent high-grade gliomas. Neurooncology 2008, 10, 162-170.
78. Gerstner, E.R.; Sorensen, A.G.; Jain, R.K.; Batchelor, T.T. Advances in neuroimaging techniques for the evaluation of tumor growth, vascular permeability, and angiogenesis in gliomas. Curr. Opin. Neurol. 2008, 21, 728-735.
79. Ullrich, R.T.; Kracht, K.W.; Jacobs, A.H. Neuroimaging in patients with gliomas. Semin. Neurol. 2008, 28, 484-494.
80. Narayana, A.; Chang, J.; Thakur, S.; Huang, W.; Karimi, S.; Hou, B.; Kowalski, A.; Perera, G.; Holodny, A.; Gutin, P.H. Use of MR spectroscopy and functional imaging in the treatment planning of gliomas. Br. J. Radiol. 2007, 80, 347-354.
81. Jena, R.; Price, S.J.; Baker, C.; Jefferies, S.J.; Pickard, J.D.; Gillard, J.H.; Burnet, N.G. Diffusion tensor imaging: Possible implications for radiotherapy treatment planning of patients with high-grade glioma. Clin. Oncol. 2005, 17, 581-590.
82. Grosu, A.L.; Weber, W.A.; Riedel, E.; Jeremic, B.; Nieder, C.; Franz, M.; Gumprecht, H.; Jaeger, R.; Schwaiger, M.; Molls, M. L-(Methyl-11C) methionine positron emission tomography for target delineation in resected high-grade gliomas before radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2005, 63, 64-74.
83. Grosu, A.L.; Weber, W.A.; Franz, M.; Stärk, S.; Piert, M.; Thamm, R.; Gumprecht, H.; Schwaiger, M.; Molls, M.; Nieder, C. Reirradiation of recurrent high-grade gliomas using amino acid PET (SPECT)/CT/MRI image fusion to determine gross tumor volume for stereotactic fractionated radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2005, 63, 511-519.
84. Stewart, L.A. Chemotherapy in adult high-grade glioma: A systematic review and meta-analysis of individual patient data from 12 randomised trials. Lancet 2002, 359, 1011-1018.