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Hypofractioned radiotherapy versus conventional radiotherapy for the treatment of multiform glioblastoma in adults over 70 years old

Published online by Cambridge University Press:  18 July 2019

Adriana Jiménez Cantero
Affiliation:
National Hospital XXI Century, Radiation Oncology Service, Instituto Mexicano del Seguro Social, Ciudad de México, México
Jessica Chávez Nogueda
Affiliation:
National Hospital XXI Century, Radiation Oncology Service, Instituto Mexicano del Seguro Social, Ciudad de México, México
Fabiola Flores Vázquez
Affiliation:
National Hospital XXI Century, Radiation Oncology Service, Instituto Mexicano del Seguro Social, Ciudad de México, México
José Pablo Castillo de la Garza
Affiliation:
National Hospital XXI Century, Radiation Oncology Service, Instituto Mexicano del Seguro Social, Ciudad de México, México
Raymundo Hernández Montes de Oca
Affiliation:
National Hospital XXI Century, Radiation Oncology Service, Instituto Mexicano del Seguro Social, Ciudad de México, México
Alejandro Olmos Guzmán
Affiliation:
National Hospital XXI Century, Radiation Oncology Service, Instituto Mexicano del Seguro Social, Ciudad de México, México

Abstract

Aim:

Multiform glioblastoma (MG) represents 70% of all gliomas, with half of patients older than 65 years with median survival of 12–18 months, hypofractionation seeks to reduce the intensity and duration of treatment without impacting on survival rates. The objective was to determine the global survival and recurrence-free survival of adults over 70 years old with MG treated with hypofractionated radiotherapy and standard scheme. The review of patients older than 70 years treated with radiotherapy from 2013 to 2016 was performed.

Results:

Twenty-four patients were analysed, with a median follow-up of 239 days, and there is no difference in overall survival 12·3 versus 10·5 months (p = 0·55) and recurrence-free survival 8·3 versus 3·4 months (p = 0·48) between both schemes, conventional versus hypofractioanted, respectively.

Conclusion:

The results in this study show that hypofractionated scheme could be comparable in overall survival and recurrence-free survival to conventional fractionation, but a longer patients’ trial should be done.

Type
Technical Note
Copyright
© Cambridge University Press 2019

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References

Almeida, J P, Chaichana, K L, Rincon-Torroella, J, Quiñones-Hinojosa, A.The value of extent of glioblastoma: clinical evidence and current approach. Curr Neurol Neurosci Rep 2015; 517 (15): 113.Google Scholar
Wen, P Y, Kesari, S.Malignant gliomas in adults. N Engl J Med 2008; 359: 492505.CrossRefGoogle ScholarPubMed
Sulman, E P, Ismaila, N, Armstrong, T Set al. Radiation therapy for glioblastoma: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation Oncology Guideline. J Clin Oncol 2016; 34: 18.Google Scholar
Huang, J, Samson, P, Perkins, S Met al. Impact of concurrent chemotherapy with radiation therapy for elderly patients with newly diagnosed glioblastoma: a review of the National Cancer Data Base. J Neurooncol 2017; 131 (3): 593601.10.1007/s11060-016-2331-6CrossRefGoogle ScholarPubMed
Stupp, R, Mason, W P, van den Bent, K Jet al. Radiotherapy plus concomitant and adyuvant temozolamide for glioblastoma. N Engl J Med 2005; 352: 987996.CrossRefGoogle Scholar
Alifieris, C, Trafalis, T D.Glioblastoma multiforme: pathogenesis and treatment. Pharmacol Ther 2015; 152: 6382.10.1016/j.pharmthera.2015.05.005CrossRefGoogle ScholarPubMed
Babu, R, Komisarow, J M, Agarwal, V J, et. al. Glioblastoma in the elderly: the effect of aggressive and modern therapies on survival. J Neurosurg 2016; 124: 9981006.CrossRefGoogle ScholarPubMed
Malmstrom, A, Gronberg, B H, Marosi, Cet al. Temozolamide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol 2012; 13: 916926.CrossRefGoogle Scholar
Roa, W, Brasher, P M A, Bauman, Get al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol 2003; 22: 15831588.10.1200/JCO.2004.06.082CrossRefGoogle Scholar
Roa, W, Kepka, L, Kumar, Net al. International atomic energy agency randomized phase iii study of radiation therapy in elderly and/or frail patients with newly diagnosed glioblastoma multiforme. J Clin Oncol 2015; 33: 41454159.CrossRefGoogle ScholarPubMed
de Castro, D G, Matiello, J, Roa, Wet al. Survival outcomes with short course radiotherapy in elderly patients with glioblastoma: data from a randomized phase III trial. Int J Radiat Oncol Biol Phys 2017; 98 (4): 931938.CrossRefGoogle Scholar
Oken, M M, Creech, R H, Tormey, D Cet al.Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982; 5: 649655.CrossRefGoogle ScholarPubMed
Bracci, S, Laigle-Donadey, F, Hitchcock, Ket al. Role of irradiation for patients over 80 years old with glioblastoma: a retrospective cohort study. J Neurooncol 2016; 129: 347353.CrossRefGoogle ScholarPubMed
Keime-Guibert, F, Chinot, O, Taillandier, Let al. Radiotherapy for glioblastoma in the elderly. N Engl J Med 2007; 356: 15271535.10.1056/NEJMoa065901CrossRefGoogle ScholarPubMed
Roa, W, Xing, J, Small, Cet al. Current developments in the radiotherapy approach to elderly and frail patients with glioblastoma multiforme. Expert Rev Anticancer Ther 2009; 9 (11): 16431650.10.1586/era.09.128CrossRefGoogle ScholarPubMed
Minniti, G, DeSanctis, V, Muni, Ret al. Hypofractioned radiotherapy followed by adjuvant chemotherapy with temozolomide in elderly patients with glioblastoma. J Neurooncol 2009; 91 (1): 95100.10.1007/s11060-008-9689-zCrossRefGoogle Scholar
Arvold, N D, Tanguturi, S K, Aizer, A Aet al. Hypofractionated versus standard radiation therapy with or without temozolomide for older glioblastoma patients. Int J Radiation Oncol Biol Phys 2015; 92 (2): 384389.10.1016/j.ijrobp.2015.01.017CrossRefGoogle ScholarPubMed
Minniti, G, Scaringi, C, Lanzetta, Get al. Standard (60 Gy) or short-course (40 Gy) irradiation plus concomitant and adjuvant temozolomide for elderly patients with glioblastoma: a propensity-matched analysis. Int J Radiation Oncol Biol Phys 2015; 91 (1): 109115.10.1016/j.ijrobp.2014.09.013CrossRefGoogle ScholarPubMed