Radiation therapy for glioblastoma: Executive summary of an American Society for Radiation Oncology Evidence-Based Clinical Practice Guideline

被引：178

作者：

Cabrera, Alvin R. ^{[1
]}

Kirkpatrick, John P. ^{[2
]}

Fiveash, John B. ^{[3
]}

Shih, Helen A. ^{[4
]}

Koay, Eugene J. ^{[5
]}

Lutz, Stephen ^{[6
]}

Petit, Joshua ^{[7
]}

Chao, Samuel T. ^{[8
]}

Brown, Paul D. ^{[5
]}

Vogelbaum, Michael ^{[9
]}

Reardon, David A. ^{[10
]}

Chakravarti, Arnab ^{[11
]}

Wen, Patrick Y. ^{[10
]}

Chang, Eric ^{[12
]}

机构：

[1] Grp Hlth Phys, Dept Radiat Oncol, Seattle, WA USA

[2] Duke Univ, Med Ctr, Dept Radiat Oncol, Durham, NC USA

[3] Univ Alabama Birmingham, Dept Radiat Oncol, Birmingham, AL USA

[4] Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USA

[5] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA

[6] Blanchard Valley Reg Hlth Ctr, Dept Radiat Oncol, Findlay, OH USA

[7] Univ Colorado Hlth, Dept Radiat Oncol, Ft Collins, CO USA

[8] Cleveland Clin, Dept Radiat Oncol, Cleveland, OH 44106 USA

[9] Cleveland Clin, Brain Tumor & Neurooncol Ctr, Cleveland, OH 44106 USA

[10] Dana Farber Canc Inst, Ctr Neurooncol, Boston, MA 02115 USA

[11] Ohio State Univ, Dept Radiat Oncol, Columbus, OH 43210 USA

[12] Univ So Calif, Keck Sch Med, Dept Radiat Oncol, Los Angeles, CA 90033 USA

来源：

PRACTICAL RADIATION ONCOLOGY | 2016年 / 6卷 / 04期

关键词：

NEWLY-DIAGNOSED GLIOBLASTOMA; QUALITY-OF-LIFE; RADIOTHERAPY PLUS CONCOMITANT; RANDOMIZED PHASE-III; ADJUVANT TEMOZOLOMIDE; MALIGNANT GLIOMA; STEREOTACTIC RADIOSURGERY; ELDERLY-PATIENTS; GRADE GLIOMAS; TRIAL;

D O I：

10.1016/j.prro.2016.03.007

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: To present evidence-based guidelines for radiation therapy in treating glioblastoma not arising from the brainstem. Methods and materials: The American Society for Radiation Oncology (ASTRO) convened the Glioblastoma Guideline Panel to perform a systematic literature review investigating the following: (1) Is radiation therapy indicated after biopsy/resection of glioblastoma and how does systemic therapy modify its effects? (2) What is the optimal dose-fractionation schedule for external beam radiation therapy after biopsy/resection of glioblastoma and how might treatment vary based on pretreatment characteristics such as age or performance status? (3) What are ideal target volumes for curative-intent external beam radiation therapy of glioblastoma? (4) What is the role of reirradiation among glioblastoma patients whose disease recurs following completion of standard first-line therapy? Guideline recommendations were created using predefined consensus-building methodology supported by ASTRO-approved tools for grading evidence quality and recommendation strength. Results: Following biopsy or resection, glioblastoma patients with reasonable performance status up to 70 years of age should receive conventionally fractionated radiation therapy (eg, 60 Gy in 2-Gy fractions) with concurrent and adjuvant temozolomide. Routine addition of bevacizumab to this regimen is not recommended. Elderly patients (>= 70 years of age) with reasonable performance status should receive hypofractionated radiation therapy (eg, 40 Gy in 2.66-Gy fractions); preliminary evidence may support adding concurrent and adjuvant temozolomide to this regimen. Partial brain irradiation is the standard paradigm for radiation delivery. A variety of acceptable strategies exist for target volume definition, generally involving 2 phases (primary and boost volumes) or 1 phase (single volume). For recurrent glioblastoma, focal reirradiation can be considered in younger patients with good performance status. Conclusions: Radiation therapy occupies an integral role in treating glioblastoma. Whether and how radiation therapy should be applied depends on characteristics specific to tumor and patient, including age and performance status. (C) 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

引用

页码：217 / 225

页数：9