Hypofractionated chemoradiotherapy with temozolomide as a treatment option for glioblastoma patients with poor prognostic features

被引:8
作者
Lim, Yu Jin [1 ]
Kim, Il Han [2 ]
Han, Tae Jin [3 ]
Choi, Seung Hong [4 ]
Park, Sung-Hye [5 ]
Park, Chul-Kee [6 ]
Paek, Sun Ha [6 ]
Lee, Se-Hoon [7 ]
Kim, Tae Min [7 ]
机构
[1] Seoul Natl Univ, Coll Med, Dept Radiat Oncol, Seoul 110744, South Korea
[2] Seoul Natl Univ, Coll Med, Canc Res Inst, Inst Radiat Med,Med Res Ctr,Dept Radiat Oncol, Seoul 110744, South Korea
[3] Hallym Univ, Coll Med, Kangdong Sacred Heart Hosp, Dept Radiat Oncol, Seoul, South Korea
[4] Seoul Natl Univ, Coll Med, Dept Radiol, Seoul 110744, South Korea
[5] Seoul Natl Univ, Coll Med, Dept Pathol, Seoul 110744, South Korea
[6] Seoul Natl Univ, Coll Med, Dept Neurosurg, Seoul 110744, South Korea
[7] Seoul Natl Univ, Coll Med, Dept Internal Med, Div Med Oncol, Seoul 110744, South Korea
基金
新加坡国家研究基金会;
关键词
Glioblastoma; Hypofractionated radiotherapy; Temozolomide; Poor performance status; Elderly; NEWLY-DIAGNOSED GLIOBLASTOMA; RADIOTHERAPY PLUS CONCOMITANT; RECURSIVE PARTITIONING ANALYSIS; HIGH-GRADE GLIOMA; ELDERLY-PATIENTS; CONCURRENT TEMOZOLOMIDE; ADJUVANT TEMOZOLOMIDE; RADIATION-THERAPY; ABBREVIATED COURSE; PHASE-3; TRIAL;
D O I
10.1007/s10147-014-0690-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Although the optimal treatment of frail glioblastoma patients is still controversial, previous randomized trials have excluded such patients. This study aimed to evaluate the feasibility and safety of hypofractionated radiotherapy (RT) with concomitant temozolomide for glioblastoma patients with poor prognostic features. Methods We retrospectively reviewed 33 glioblastoma patients who underwent postoperative hypofractionated chemoradiotherapy. The patient criteria were either >= 70 years or <70 years with one or more risk factors: pre-RT performance status (ECOG score) >= 3, biopsy only, or rapid disease progression immediately after surgery. The median RT dose was 45 Gy (range 30-45) with a fraction size of 3 Gy. Results The median age was 66.0 years. Eighteen patients (55 %) had poor pre-RT performance status (ECOG >= 3), and 16 patients (48 %) underwent stereotactic biopsy only. The median overall survival (OS) and progression-free survival were 10.6 and 7.5 months, respectively. Poor pre- and post-RT performance status [hazard ratio (HR) 3.12, 95 % confidence interval (CI) 1.21-8.07 and HR 4.51, 95 % CI 1.44-14.12, respectively] and no pseudoprogression (HR 5.43, 95 % CI 1.58-18.61) were associated with poorer OS. While acute neurologic symptoms were reported in 5 patients (15 %), toxicity profiles were acceptable without treatment-related aggravation of performance status. Conclusions Concurrent chemoradiotherapy with temozolomide, the current standard treatment after surgery for glioblastoma, could be shortened without increasing side effects for patients with poor prognostic features.
引用
收藏
页码:21 / 28
页数:8
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