A phase i study of tomotherapy in patients with primary benign and low-grade brain tumors: Late toxicity and quality of life
American Journal of Clinical Oncology: Cancer Clinical Trials
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Objectives: To evaluate longitudinal quality of life and late neurotoxicity (> 12 mo) of tomotherapy in patients with primary benign and low-grade brain tumors. Methods: Between January 2006 and October 2009, 49 patients with brain tumors were treated with tomotherapy at 2 radiotherapy centers in Canada. The median age of the patients was 51.0 years (range, 21 to 74 y); there were 21 men (42.86%) and 28 women (57.14%). All 49 patients had an initial Karnofsky performance score Z70. One patient (2.04%) received 45 Gy in 25 fractions, 27 patients (55.10%) received 50.4 Gy in 28 fractions, 15 patients (30.6%) received 54 Gy in 30 fractions, and 5 patients (10.2%) received 60 Gy in 30 fractions. A total of 47 patients were analyzed for late toxicity and outcomes. Results: Changes in the Karnofsky Performance Status of the patients did not reach statistical significance (P > 0.05). The majority of the quality of life parameters that reached a statistically significant level (P < 0.05) of change at 2 years were changes toward improvement (drowsiness, itchy skin, emotional functioning, fatigue, nausea, and appetite). Statistically significant (P < 0.05) interval deterioration in physical, role, and social functioning was observed. Actuarial overall survival at 5 years was 91.6%; disease-free survival at 5 years was 86.6%. Conclusions: IMRT helical tomotherapy is well tolerated, without statistically significant constitutional and late neurotoxicity up to the 2-year mark.