Hypofractionated radiotherapy as palliative treatment in poor prognosis patients with high grade glioma

Thomas, R.; James, Nicholas D.; Guerrero, D.; Ashley, S.; Gregor, A.; Brada, Michael

doi:10.1016/0167-8140(94)90064-7

Cited by 77 publications

(32 citation statements)

References 16 publications

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“…In patients > 50 years, with low performance, short symptom time and irresectability of the tumor, the prognosis is poor and will clinically not be significantly modified by radiotherapy [10,20,38]. This major influence of prognostic factors also led to the introduction of short-course radiotherapy in the poor prognostic groups [3,20,43]. The Groningen experience is similar, with all prognostic variables of independent prognostic significance.…”

Section: Radiotherapy and Glioblastoma Multiformementioning

confidence: 71%

Radiotherapy in Supratentorial Gliomas

Heesters

Molenaar

2003

Strahlenther Onkol

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Section: Radiotherapy and Glioblastoma Multiformementioning

confidence: 71%

Radiotherapy in Supratentorial Gliomas

Heesters

Molenaar

2003

Strahlenther Onkol

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“…Distribution of patients over the prognostic groups was similar with others ( tensive hypofractionated course in this study resulted in a similar survival with a similar palliative effect compared to the conventional fractionated scheme. Hypofractionated radiotherapy was tested in a few other phase-II studies, using fraction doses of 3-5 Gy, mainly in a subgroup of poor prognosis patients [1,9,12,20,24]. They all concluded that survival results were comparable to those achieved after conventional radiotherapy without increasing toxicity.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Glioblastoma Multiforme 10 Years Experience of a Single Institution

et al. 2001

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Despite technical developments in surgery and radiotherapy over the last 10 years, survival of patients with a glioblastoma multiforme has not improved in our institution. The analysis of prognostic factors corresponded well with data from the literature. A short hypofractionated scheme seems to be a more appropriate treatment for patients with intermediate or poor prognosis as compared to a conventional scheme. The benefit in median survival for patients treated with an interstitial boost is partly explained by patient selection. Since there were no long-term survivors with this boost treatment, its clinical value, if there is one, is still limited.

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“…Patients with WHO grade I or II glioma usually received 54-55 Gy (69%), but 14% received 60 Gy (usually because of enhancement on imaging). In 1991, a regime of 30 Gy in six fractions delivered on alternate days over 2 weeks was introduced for the treatment of poor prognosis patients with high-grade glioma [42,45]. In this study 230 patients received such treatment, 219 with WHO grade III or IV lesion and 11 patients without pathology (see below for age and clinical differences).…”

Section: Resultsmentioning

confidence: 99%

Trends in classification, referral and treatment and the effect on outcome of patients with glioma: a 20 year cohort

et al. 2011

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This retrospective audit was conducted to examine the changes in patient characteristics, referral, treatment and outcome over a 20-year period in a large regional neuro-oncology centre, focusing on the impact of the changes in pathological classification of gliomas. Using the Edinburgh Cancer Centre (ECC) database all cases of glioma were identified and patient, tumour and treatment characteristics noted. Survival was calculated from date of surgery or, if no operation was performed, the date of referral. Comparison was made between four periods 1988-1992 (c1), 1993-1997(c2), 1998-2002(c3) and 2003-2007 (c4). During the 20 years, 1175 patients with a glioma were referred to ECC. The median age increased from 53 years to 57 years (p < 0.001) but the proportion without pathology remained unchanged (10%). The distribution of pathological grades changed over time Grade I-II: 24, 6, 6, and 6%, Grade III: 42, 27, 17, and 13% and Grade IV: 24, 61, 68, and 68% in c1, c2, c3 and c4, respectively (p < 0.001). Immediate RT was given to 68% (c1), 70% (c2), 78% (c3) and 79% (c4). Median interval from resection to RT reduced from 43 days (c1) to 36 days (c4) (p < 0.001). 5-year overall survival for patients with Grade III lesions increased: 21% (c1), 35% (c2), 37% (c3), 33% (c4) as did 1-year overall survival for Grade IV lesions: 18% (c1), 26% (c2), 29% (c3), 27% (c4)). This improvement probably reflects the change in pathological classification rather than a change in management. Proportional hazards analysis of grade IV 1993-2007 only (to reduce pathological variation) showed that younger age, frontal lesions, excision, higher RT dose had reduced hazard of death. Interval from surgery to RT had no impact on survival in this series.

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Hypofractionated radiotherapy as palliative treatment in poor prognosis patients with high grade glioma

Cited by 77 publications

References 16 publications

Radiotherapy in Supratentorial Gliomas

Radiotherapy in Supratentorial Gliomas

Prognostic Factors in Glioblastoma Multiforme 10 Years Experience of a Single Institution

Trends in classification, referral and treatment and the effect on outcome of patients with glioma: a 20 year cohort

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