- I. Compare overall survival at 12 months for grade IV glioma patients after radiation therapy
targeting volumes designed with both 18F-DOPA-PET and conventional magnetic resonance (MR)
image (or PET/computed tomography [CT]) information with historical controls.
- I. Compare progression free survival at 12 months after radiation therapy targeting volumes
designed with both 18F-DOPA-PET and conventional MR image information with historical
- II. Determine acute and late effect toxicity after hypofractionated proton beam radiotherapy
treatment including areas of high 18F-DOPA-PET uptake (T/N > 2.0).
CORRELATIVE RESEARCH OBJECTIVES:
- I. Compare radiotherapy (RT) treatment volumes defined by MR only with RT treatment volumes
defined with both PET and MR information for grade IV glioma patients.
- II. Compare differences in RT volumes identified using biopsy-validated thresholds as highly
aggressive disease comparing 18F-DOPA uptake and relative cerebral blood volume (relCBV) from
perfusion MRI (pMRI) as well as differences in RT volumes identified using biopsy-validated
thresholds as tumor extent comparing 18F-DOPA uptake and diffusion maps from diffusion tensor
imaging (DTI) will be evaluated.
- III. Evaluate quality of life after radiotherapy using European Organization for Research and
Treatment of Cancer (EORTC) questionnaires compared with historical controls from
Keim-Guibert et al.
- IV. Compare differences in proton radiation planning utilizing radiobiologic
modeling/evaluation techniques performed at Mayo Clinic Rochester to linear energy transfer
distribution evaluation at Mayo Clinic Arizona.
Patients receive 18F-DOPA intravenously (IV) and undergo PET/MRI or PET/CT imaging scan.
Patients then receive proton beam radiotherapy over 5 or 10 consecutive days excluding
weekend and standard of care temozolomide on days 1-7 or 1-14. Beginning course 2, patients
receive standard of care temozolomide on days 1-5. Courses with temozolomide repeat every 28
days for up to 7 courses in the in the absence of disease progression or unacceptable
After completion of study treatment, patients are followed up every 2 months for 1 year, and
then periodically for up to 5 years.