Hypofractionated radiotherapy for poor prognosis malignant glioma: matched pair survival analysis with MRC controls

McAleese, J.; Stenning, Sally; Ashley, S.; Traish, D.; Hines, Frances; Sardell, S.; Guerrero, D.; Brada, Michael

doi:10.1016/s0167-8140(03)00077-x

Cited by 62 publications

(50 citation statements)

References 20 publications

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“…This change probably reflects the attempts of many clinical researchers to identify hypofractionated schemes suitable for palliation for poorprognosis patients (17)(18)(19)(20). The Neuro Oncology Disease Group of the Cancer Care Ontario Practice Guidelines Initiative states that "this option would be particularly appropriate for patients who are both older and with poor performance status" (12).…”

Section: Pattern-of-practice Analysismentioning

confidence: 99%

“…These patients represents more than half of our series, and the evaluation of NPS before an appropriate treatment option is chosen is therefore of the utmost importance. Recent reports, in fact, suggest that, especially for poor-prognosis HGG, "quality adjusted survival" or "good quality survival" (strongly linked with neurologic status) is a better measure of outcome than uncorrected survival (30,31).…”

Section: Survival Analysismentioning

confidence: 99%

See 1 more Smart Citation

Patterns of practice and survival in a retrospective analysis of 1722 adult astrocytoma patients treated between 1985 and 2001 in 12 Italian radiation oncology centers

Magrini

Ricardi

Santoni

et al. 2006

International Journal of Radiation Oncology*Biology*Physics

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Section: Pattern-of-practice Analysismentioning

confidence: 99%

Section: Survival Analysismentioning

confidence: 99%

Patterns of practice and survival in a retrospective analysis of 1722 adult astrocytoma patients treated between 1985 and 2001 in 12 Italian radiation oncology centers

Magrini

Ricardi

Santoni

et al. 2006

International Journal of Radiation Oncology*Biology*Physics

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“…Hulshof et al [28] found that the median survival for patients treated with 40 Gy/ 8 fractions or 28 Gy/ 4 fractions, were 7-and 5.6-months, respectively. McAleese et al [30] in a comparative study of hypofractionated radiation (using 30 Gy/6 fractions / 2 weeks) to GBM patients versus conventional method of 60 Gy /30 fractions /6 weeks found that median survival was higher among the conventional arm but was not statistically significant. Chang et al [ 29] in a higher dose schedule (50 Gy/20 fractions at 2.5 Gy per fraction) found that the median survival was 7 months.…”

Section: Discussionmentioning

confidence: 98%

Glioblastoma Multiform: Analysis of Patients Treated with Radiotherapy at King Abdulaziz University Hospital

Bahadur¹

2006

med

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Abstract. Treatment of Glioblastoma Multiform typically involves maximal surgical resection, followed by adjuvant radiation therapy. In this study, all patients with GBM treated with radiation therapy after initial surgical intervention at King Abdulaziz University Hospital were reviewed. From April, 2000 to December 2002, 13 patients were treated, 9 (69%) males and 4 (31%) females. Two (15%) patients had near complete resection, one (8%) had biopsy only and 10 (77%) had partial resection. Radiation therapy was given on palliative intent in 10 (77%) patients with dose of 24-30 Gy, and 3 (23%) cases treated radically with dose of 54-60 Gy. Radiological follow-up after 6-8 weeks from completion of radiation therapy showed complete response in 8%, partial response in 38%, stable disease in 8%, disease progression in 38% and 8% did not have their radiologic evaluation. Evaluation after one year showed overall survival rate was 36%, the median survival time was 9.5 months; the median time to disease progression was 6 months. Radiation therapy provided good palliation for these patients.

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“…These results are in keeping with some of the empirical results on hypofractionated therapy. For example, the work of McAleese et al (29) compared an accelerated hypofractionated protocol consisting of 30 Gy in 6 fractions to matched controls receiving a standard 60 Gy/30 fraction protocol, and found that although the hypofractionated protocol had a palliative benefit, it showed a shorter median survival of 2.5-4.5 months compared to the standard protocol. Of course, the objective of the present study is not to rigorously compare hypofractionated to standard protocols, but the simulation is presented to show the utility of the current model.…”

Section: Discussionmentioning

confidence: 99%

A 3-dimensional DTI MRI-based model of GBM growth and response to radiation therapy

Hathout

Patel

Wen

2016

International Journal of Oncology

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Abstract. Glioblastoma (GBM) is both the most common and the most aggressive intra-axial brain tumor, with a notoriously poor prognosis. To improve this prognosis, it is necessary to understand the dynamics of GBM growth, response to treatment and recurrence. The present study presents a mathematical diffusion-proliferation model of GBM growth and response to radiation therapy based on diffusion tensor (DTI) MRI imaging. This represents an important advance because it allows 3-dimensional tumor modeling in the anatomical context of the brain. Specifically, tumor infiltration is guided by the direction of the white matter tracts along which glioma cells infiltrate. This provides the potential to model different tumor growth patterns based on location within the brain, and to simulate the tumor's response to different radiation therapy regimens. Tumor infiltration across the corpus callosum is simulated in biologically accurate time frames. The response to radiation therapy, including changes in cell density gradients and how these compare across different radiation fractionation protocols, can be rendered. Also, the model can estimate the amount of subthreshold tumor which has extended beyond the visible MR imaging margins. When combined with the ability of being able to estimate the biological parameters of invasiveness and proliferation of a particular GBM from serial MRI scans, it is shown that the model has potential to simulate realistic tumor growth, response and recurrence patterns in individual patients. To the best of our knowledge, this is the first presentation of a DTI-based GBM growth and radiation therapy treatment model.

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Hypofractionated radiotherapy for poor prognosis malignant glioma: matched pair survival analysis with MRC controls

Cited by 62 publications

References 20 publications

Patterns of practice and survival in a retrospective analysis of 1722 adult astrocytoma patients treated between 1985 and 2001 in 12 Italian radiation oncology centers

Patterns of practice and survival in a retrospective analysis of 1722 adult astrocytoma patients treated between 1985 and 2001 in 12 Italian radiation oncology centers

Glioblastoma Multiform: Analysis of Patients Treated with Radiotherapy at King Abdulaziz University Hospital

A 3-dimensional DTI MRI-based model of GBM growth and response to radiation therapy

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