Immediate post-operative brachytherapy prior to irradiation and temozolomide for newly diagnosed glioblastoma

Waters, J. Dawn; Rose, Brent S.; Gonda, David; Scanderbeg, Daniel J.; Russell, Mary Jo; Alksne, John F.; Murphy, Karen L.; Carter, Bob S.; Lawson, Joshua D.; Chen, Clark C.

doi:10.1007/s11060-013-1139-x

Cited by 29 publications

(20 citation statements)

References 45 publications

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“…In the present study, the analysis of high-dose radiotherapy was not performed as the results are well established. In addition, under the conditions that normal brain tissues are protected and the radiation reactions are reduced, little improvement remains to be achieved in current radiotherapy measures ( 25 , 26 ). Certain previous studies have indicated that radiation treatment at low doses between 5–8 Gy exhibits a promotional effect on the invasion abilities of tumour cells.…”

Section: Discussionmentioning

confidence: 99%

Effects of combined radiosurgery and temozolomide therapy on epidermal growth factor receptor and variant III in glioblastoma multiforme

Lin

Zhou

et al. 2018

Oncol Lett

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Glioblastoma multiforme (GBM) is a highly malignant and notably aggressive primary tumour. Variant III of the epidermal growth factor receptor (EGFRvIII) is one of the most common types of variants in GBM, and serves an important role in tumour invasion, proliferation and treatment resistance. In the present study, statistical analyses were performed on data from 57 patients with GBM, and polymerase chain reaction detection was conducted on the tumour tissues from 32 of these patients. The results indicated that the EGFRvIII mutation was significantly associated with tumour malignancy. Human GBMU87-EGFRvIII cell lines were cultured and treated with radiosurgery and temozolomide individually, or with combined radiosurgery and temozolomide treatment. In vitro and in vivo experimental methods were used to detect the expression levels of Ki-67 and EGFRvIII. As verified in the present study, the EGFRvIII mutation is positively correlated with the malignancy of tumours, and combined radiosurgery and temozolomide therapy may inhibit the invasion and proliferation abilities of U87-EGFRvIII more effectively than treatment alone.

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Section: Discussionmentioning

confidence: 99%

Effects of combined radiosurgery and temozolomide therapy on epidermal growth factor receptor and variant III in glioblastoma multiforme

Lin

Zhou

et al. 2018

Oncol Lett

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“…Most of these more recent trials report survival outcomes that are comparable to historical data of other multi-modality treatments. There are no prospective, randomized studies of GliaSite in the treatment of malignant glioma [65,66].…”

Section: Determining the Optimal Rt Field Sizementioning

confidence: 99%

Radiation Therapy of Glioblastoma

Barani

Larson

2014

Cancer Treatment and Research

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Glioblastoma multiforme (GBM) is the most common malignant brain tumor that affects approximately 17,000 patients annually. Clear survival advantages have been demonstrated with postoperative radiation therapy (RT) to doses of 5,000-6,000 cGy but dose-escalation attempts beyond 6,000 cGy have resulted in increased toxicity but no additional survival benefit. To improve local control and limit toxicity to normal brain tissue with these infiltrating tumors, novel imaging techniques are actively being explored to better define tumor extent and associated RT treatment fields. Hyperfractionated RT has been associated with a survival detriment. Current standard-of-care treatment involves concurrent use of temozolomide and RT to 6,000 cGy over 30 days followed by adjuvant temozolomide treatment for 6 months. Brachytherapy and stereotactic radiosurgery are effective therapies for relapsed GBM but tend to be associated with notable toxicity. More recently, re-irradiation strategies employ concurrent use of bevacizumab to limit treatment-related injury while still permitting delivery of meaningful doses. These clinical trials are ongoing and merits of these strategies are not yet clear but appear promising.

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“…A number of strategies for modifying the delivery of RT (4–6) have been tested, without an improvement in survival. Integration of cytotoxic agents as radiation modifiers into GBM treatment protocols (7) has been disappointing.…”

Section: Introductionmentioning

confidence: 99%

A Phase 2 Study of Concurrent Radiation Therapy, Temozolomide, and the Histone Deacetylase Inhibitor Valproic Acid for Patients With Glioblastoma

Krauze

Myrehaug

Chang

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

160

105

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Purpose Valproic acid (VPA) is an antiepileptic agent with histone deacetylase inhibitor (HDACi) activity shown to sensitize glioblastoma (GBM) cells to radiation in pre-clinical models. We evaluated the addition of VPA to standard radiation therapy (RT) and temozolomide (TMZ) in patients with newly diagnosed GBM. Methods and Materials Thirty-seven patients with newly diagnosed GBM were enrolled between July 2006 and April 2013. Patients received VPA, 25 mg/kg orally, divided into 2 daily doses concurrent with RT and TMZ. The first dose of VPA was given 1 week before the first day of RT at 10 to 15 mg/kg/day and subsequently increased up to 25 mg/kg/day over the week prior to radiation. VPA- and TMZ-related acute toxicities were evaluated using Common Toxicity Criteria version 3.0 (National Cancer Institute Cancer Therapy Evaluation Program) and Cancer Radiation Morbidity Scoring Scheme for toxicity and adverse event reporting (Radiation Therapy Oncology Group/European Organization for Research and Treatment). Results A total of 81% of patients took VPA according to protocol. Median overall survival (OS) was 29.6 months (range: 21–63.8 months), and median progression-free survival (PFS) was 10.5 months (range: 6.8–51.2 months). OS at 6, 12, and 24 months was 97%, 86%, and 56%, respectively. PFS at 6, 12, and 24 months was 70%, 43%, and 38% respectively. The most common grade 3/4 toxicities of VPA in conjunction with RT/TMZ therapy were blood and bone marrow toxicity (32%), neurological toxicity (11%), and metabolic and laboratory toxicity (8%). Younger age and class V recursive partitioning analysis results were significant for both OS and PFS. VPA levels were not correlated with grade 3/4 toxicity levels. Conclusions Addition of VPA to concurrent RT/TMZ in patients with newly diagnosed GBM was well tolerated. Additionally, VPA may result in improved outcomes compared to historical data and merits further study.

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Immediate post-operative brachytherapy prior to irradiation and temozolomide for newly diagnosed glioblastoma

Cited by 29 publications

References 45 publications

Effects of combined radiosurgery and temozolomide therapy on epidermal growth factor receptor and variant III in glioblastoma multiforme

Effects of combined radiosurgery and temozolomide therapy on epidermal growth factor receptor and variant III in glioblastoma multiforme

Radiation Therapy of Glioblastoma

A Phase 2 Study of Concurrent Radiation Therapy, Temozolomide, and the Histone Deacetylase Inhibitor Valproic Acid for Patients With Glioblastoma

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