A short fractionation radiotherapy treatment for poor prognosis patients with high grade glioma

Ford, Judith M.; Stenning, SP; Boote, D.J.; Counsell, R.; Falk, S.; Flavin, Aileen; Laurence, V.M.; Bleehen, Norman M.

doi:10.1016/s0936-6555(97)80053-2

Cited by 41 publications

(31 citation statements)

References 14 publications

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“…28 patients completed treatment as planned and the MS for the whole group was 16 weeks, with 7 patients surviving for more than 6 months. A matched case-control comparison with data from patients in previous MRC studies showed that these results were similar to conventional fractionation for this group of patients [22].…”

Section: Resultssupporting

confidence: 69%

“…Ford et al [22] reported on a small UK prospective series of 32 patients with high-grade glioma and poor prognostic features [Medical Research Council (MRC) prognostic score .25] treated at the Addenbrookes Hospital Cambridge, UK, with a dose of 36 Gy in 12 fractions to the tumour and surrounding oedema with a 2 cm margin. 28 patients completed treatment as planned and the MS for the whole group was 16 weeks, with 7 patients surviving for more than 6 months.…”

Section: Resultsmentioning

confidence: 99%

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Hypofractionated radiotherapy for glioblastoma: strategy for poor-risk patients or hope for the future?

Hingorani¹,

Colley²,

Dixit³

et al. 2012

BJR

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ABSTRACT. The prognosis of patients with glioblastoma (GBM) remains poor, and the use of hyperfractionation or dose escalation beyond 60 Gy has not conferred any survival benefit. More recently, hypofractionated radiotherapy (HFRT) has been employed as a novel approach for achieving dose escalation, with interesting results. We present here a systematic overview of the role and development of HFRT as a possible therapeutic strategy in patients with GBM. We searched the PubMed database for studies published since 1990 that reported on the tolerance, safety and survival outcomes after HFRT. These studies reported on the paradox of improved survival in patients developing central radionecrosis within the high-dose volume. Most series reported no significant increase in early or late toxicity, except for one study that reported visual loss in one patient at 7 months after treatment. More recently, studies of HFRT combined with concurrent temozolomide (TMZ) reported a trend towards improved survival compared with historical controls, with a few studies reporting a median survival of approximately 20 months. The interpretation of data from the above studies is limited by the heterogeneities of patient population and the significant variation in the range of employed dose schedules. However, high-dose HFRT using intensity-modulated radiotherapy appears to be a safe and feasible therapeutic option. There is a suggestion of improved outcomes on combining HFRT with TMZ, which warrants further investigation in a randomised trial.

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Section: Resultssupporting

confidence: 69%

Section: Resultsmentioning

confidence: 99%

Hypofractionated radiotherapy for glioblastoma: strategy for poor-risk patients or hope for the future?

Hingorani¹,

Colley²,

Dixit³

et al. 2012

BJR

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“…[39][40][41][42][43][44][45] Recent randomized studies have documented improved survival with RT versus supportive care, and no difference in survival with a 3-week course of RT versus a 6-week course. 39,46 A larger randomized study (Nordic trial) has also shown the clear absence of any detrimental effect of short-course RT versus 6 weeks in patients age 60 or older.…”

Section: Discussionmentioning

confidence: 99%

“…[40][41][42][43][44][45] Eventually, Roa and colleagues in Canada performed a randomized study of short course RT (40 Gy in 15 fractions in 3 weeks) versus standard RT (60 Gy in 30 fractions in 6 weeks) in 100 patients aged 60 or older and a KPS of 50 or higher. 46 Median survivals were 5.6 months for the 3-week course of RT and 5.1 months for the 6-week course of RT (p = 0.63).…”

Section: Radiotherapymentioning

confidence: 99%

Optimal management of elderly patients with glioblastoma

Laperrière¹,

Weller²,

Stupp³

et al. 2013

Cancer Treatment Reviews

131

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“…Amongst these only one trial, by Maarten [45] et al, prospectively compared hypofractionated radiation with conventional fractionation and no significant differences were found between the two in terms of palliative effect as well as survival. Two other trials [42,46] compared hypofractionated RT with matched historical controls from previous MRC cohorts treated with conventional fractionation (60 Gy/30 fractions). Although the median survival of patients treated with hypofractionated RT was lesser (by 2.5 Á/4.5 months) than matched controls, the improvement in QOL was reasonably comparable.…”

Section: Trials Using Hypofractionated Radiotherapy Alonementioning

confidence: 99%

Modified optimal fractionation for poor prognosis malignant gliomas: An elusive search

Gupta

Dinshaw

2005

Acta Oncologica

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The prognosis of malignant gliomas has not changed much over the last few decades despite refinements in neurosurgical techniques, high-precision radiotherapy, and newer chemotherapeutic agents. The median survival of poor prognosis malignant gliomas (older and/or poor performance status patients) still remains in the range of 6 Á/9 months following maximal safe resection and postoperative conventionally fractionated adjuvant radiotherapy with or without chemotherapy. However, six weeks of daily radiotherapy does seem inappropriate in relation to the short expected survival time in this subset and there is an increasing emphasis on reducing the overall treatment time and the number of hospital visits by such patients. This can be achieved either by accelerated radiotherapy or by hypofractionated radiation, both of which are equivalent to conventional fractionation in terms of palliative effect and survival, as in discussed in this review. Despite enough evidence, such alteration of fractionation has not gained widespread acceptance by the oncologic fraternity. This review has been conducted to collate the evidence that could help shift the paradigm from conventional to modified fractionation in poor prognosis malignant glioma patients.

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A short fractionation radiotherapy treatment for poor prognosis patients with high grade glioma

Cited by 41 publications

References 14 publications

Hypofractionated radiotherapy for glioblastoma: strategy for poor-risk patients or hope for the future?

Hypofractionated radiotherapy for glioblastoma: strategy for poor-risk patients or hope for the future?

Optimal management of elderly patients with glioblastoma

Modified optimal fractionation for poor prognosis malignant gliomas: An elusive search

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