Short-course radiotherapy in elderly patients with glioblastoma: feasibility and efficacy of results from a single centre

Fariselli, Laura; Pinzi, Valentina; Milanesi, I.; Silvani, Antonio; Marchetti, M.; Farinotti, Mariangela; Salmaggi, Andrea

doi:10.1007/s00066-013-0346-x

Cited by 8 publications

(3 citation statements)

References 49 publications

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“…Our suggestions confirm those reported by Mineo et al 2007 who also revealed that the influence of radiotherapy on survival was greater than the influence of age [16] . Also, it has been suggested that the hypofractionated radiotherapy can be a safe and effective option in the treatment of GBM in elderly patients with a KPS >70 [37,38] . Additionally, Johnson et al revealed that patients not treated with radiation therapy had extremely poor prognoses, with a median survival following diagnosis of approximately 3 months [39] .…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors of survival in Moroccan patients with Glioblastoma

Hilmani¹,

Barakat²,

Kamar³

et al. 2014

JST

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Background: Glioblastoma is the most common and aggressive type of glioma and has the poorest survival. Some parameters have been identified as potential prognostic factors for patients with glioblastoma. The purpose of this study is to examine the influence of clinical, tumor and treatment factors on overall survival in Moroccan patients with newly diagnosed glioblastoma. Methods: In this study, we retrospectively analyzed data from 89 Moroccan patients with newly diagnosed Glioblastoma (54 males and 35 females). The effect of different prognostic factors on survival was evaluated using Kaplan-Meier method and log rank test for univariate analysis; and Cox regression method for multivariate analysis to identify the independent prognostic factors. Results: The Median age of patients at diagnosis was 52 years (range 11-84 years) and the male/female ratio was 1.54/1. The median of pre-operative Karnofsky Performance Score (KPS) was 70 (95% CI: 60-70) and the median overall survival was 12 months (95%: 9-13 months). According to univariate analysis, age (p = 0.0088), KPS (p = 0.0001) and radiation treatment (p < 0.0001) parameters were significantly associated with survival. In addition, the tumor size, KPS and radiotherapy parameters were significantly associated with survival in multivariate Cox analysis (p < 0.05). However, extent of tumor resection, gender, chemotherapy and clinical history delay factors were not found significant in both analyses (p > 0.05). Conclusion: Our results showed the strong prognostic value of age, performance score, and treatment with radiotherapy for glioblastoma patients validating the results published in previous studies. This work could contribute towards informing further research on prognostic variables for patients with glioblastoma.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors of survival in Moroccan patients with Glioblastoma

Hilmani¹,

Barakat²,

Kamar³

et al. 2014

JST

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“…Moreover, this schedule could reduce discomfort for the patients, reducing the number of days patients must devote to RT and possibly improving their quality of life (19).…”

Section: Introductionmentioning

confidence: 99%

Short Course Radiotherapy Concomitant with Temozolomide in GBM Patients: A Phase II Study

Fariselli

Cuppini

Gaviani

et al. 2017

Tumori

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“…In elderly patients, however, concomitant temozolomide should be used more cautiously [ 13 ]. Fariselli et al suggest a hypofractionated regimen with 45 Gy as a safe option for elderly patients [ 14 ]. However the Nordic trial and NOA-08 suggest additionally a monotherapy with temozolomide for elderly patients with a methylated MGMT promoter sequence [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Hippocampal EUD in primarily irradiated glioblastoma patients

et al. 2014

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BackgroundRadiation delivery for malignant brain tumors is gradually becoming more precise. Particularly the possibilities of sparing adjacent normal structures such as the hippocampus are increasing. To determine its radiation exposure more exactly, the equivalent uniform dose (EUD) of the hippocampus was compared with further treatment parameters. This way sparing options could be found.MethodsFrom the database of the University hospital of Munich 61 glioblastoma patients were selected who received primary radiotherapy in 2011. General data about the etiology, treatment course, survival of the patients and dose parameters were retrieved.ResultsIn a linear regression analysis the side of the tumor (left hippocampus: p < 0.001/right hippocampus: p = 0.009) and its temporal location (left hippocampus: p = 0.015/right hippocampus: p = 0.033) were identified as factors with a significant influence on the EUD of the respective hippocampus. Besides this, the size of the planning target volume (PTV) and the EUD of the hippocampus correlated significantly (p = 0.027; Pearson correlation = 0.291). The median PTV size of the tumor in the right hemisphere was 386.1 ml (range 131.2–910.7 ml), and in the left hemisphere 291.3 ml (range 146.0–588.9 ml) (Kruskal–Wallis test: p = 0.048). A dose quartile analysis showed that 31 patients had a high dose exposure of the hippocampus on one side while having a moderate dose exposure in the other side.ConclusionsThe radiation exposure of the respective hippocampus is dependent on the side where the tumor is located as well as on whether it is temporally located. The exposure of the contralateral hippocampus is further dependent on multiple additional factors – nevertheless a reasonable protection seems to be possible in about half of all cases.

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Short-course radiotherapy in elderly patients with glioblastoma: feasibility and efficacy of results from a single centre

Abstract: Our findings suggest that a hypofractionated accelerated schedule can be a safe and effective option in the treatment of GBM in the elderly.

Cited by 8 publications

References 49 publications

Prognostic factors of survival in Moroccan patients with Glioblastoma

Prognostic factors of survival in Moroccan patients with Glioblastoma

Short Course Radiotherapy Concomitant with Temozolomide in GBM Patients: A Phase II Study

Hippocampal EUD in primarily irradiated glioblastoma patients

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