Assessment of compliance to treatment and efficacy of a resource-sparing hypofractionated radiotherapy regimen in patients with poor-prognosis high-grade gliomas

Abstract

The treatment compliance to a resource-sparing once-weekly hypoRT regimen in poor-prognosis HGG has been somewhat suboptimal and discouraging, possibly due to the protracted scheduling over six weeks. Over 60% of patients were on treatment for two weeks, suggesting that short-course schedules could more likely ensure compliance.

Indian data on central nervous tumors: A summary of published work

“…[47] A possible role of reactive oxygen species was also demonstrated for pediatric GBMs. The first report of genome-wide profiling of miRNA and small nucleolar RNA in samples from 14 patients with pediatric high-grade gliomas has been carried out by Jha et al [48] On unsupervised hierarchical Jalali et al [27] GBM 42 RT b + TMZ f/b 6# TMZ 16.4 KPS >80% -better outcomes Grade 3 leucopenia -2% Grade 3/4 thrombocytopenia -7% during treatment Anand et al [28] HGG 46 RT + TMZ f/b 6# TMZ 15 At 3 m -Grade 3 neurotoxicity (radiologically) seen in 2.7% Kumar et al [29] GBM Chemotherapy (TMZ/lomustine) in 24.7% only Prognostic factors for survival were: site and location of tumor, dose of RT (<60 vs. 60), and use of chemotherapy Julka et al [30] GBM 215 RT + TMZ f/b 6# TMZ 13 Presentation without seizures and 6 cycles of adjuvant TMZ were significant prognostic factors Gupta et al [31] Poor prognosis HGG c…”

Radiotherapy scheduling using prime numbers

“…Algorithms facilitating the prioritisation of patients 7 , 8 and out-of-hours appointments 9 , 10 were reported to minimise delays. The introduction of short-course radiation therapy regimen or hypofractionated radiation therapy regimen was proposed as an alternative to conventional treatments, to spare resources and improve compliance in certain categories of patients such as those with poor prognosis 11 , 12 . Short-course regimens have the potential to increase patient throughput and reduce costs 13 …”

“…The introduction of short-course radiation therapy regimen or hypofractionated radiation therapy regimen was proposed as an alternative to conventional treatments, to spare resources and improve compliance in certain categories of patients such as those with poor prognosis. 11,12 Short-course regimens have the potential to increase patient throughput and reduce costs. 13 Over a century ago, Bergonié and Tribondeau observed in epithelial tumours that the radiosensitivity of a cell is directly proportional to its reproductive activity 14 and proposed that radiation therapy should ideally be administered to a cell whenever it is at the peak of its reproductive activity.…”