Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis

Melo, Suely Maymone de; Marta, Gustavo Nader; Latorraca, Carolina de Oliveira Cruz; Martins, Camila Bertini; Efthimiou, Orestis; Riera, Rachel

doi:10.1371/journal.pone.0257384

Cited by 10 publications

(2 citation statements)

References 33 publications

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“…A systematic review and network meta-analysis (NMA) also showed that OS estimates from NMA did not provide strong evidence of a difference between different hypofractionated radiotherapies of 40 Gy versus 45 Gy; 34 Gy versus 45 Gy; 25 Gy versus 45 Gy; 34 Gy versus 40 Gy and 25 Gy versus 34 Gy ( 99 ). A multi-institutional retrospective study in Korea reported that conventional radiotherapy significantly improved OS compared with short-course radiotherapy in selected elderly patients amenable to chemoradiation ( 100 ).…”

Section: Future Perspectivesmentioning

confidence: 99%

Optimal managements of elderly patients with glioblastoma

Arakawa

Mineharu

Uto

et al. 2022

Japanese Journal of Clinical Oncology

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Optimizing the management of elderly patients with glioblastoma is an ongoing task in neuro-oncology. The number of patients with this tumor type is gradually increasing with the aging of the population. Although available data and practice recommendations remain limited, the current strategy is maximal safe surgical resection followed by radiotherapy in combination with temozolomide. However, survival is significantly worse than that in the younger population. Surgical resection provides survival benefit in patients with good performance status. Hypofractionated radiotherapy decreases toxicities while maintaining therapeutic efficacy, thus improving treatment adherence and subsequently leading to better quality of life. The intensity of these treatments should be balanced with patient-specific factors and consideration of quality of life. This review discusses the current optimal management in terms of efficacy and safety, as well as future perspectives.

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Section: Future Perspectivesmentioning

confidence: 99%

Optimal managements of elderly patients with glioblastoma

Arakawa

Mineharu

Uto

et al. 2022

Japanese Journal of Clinical Oncology

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“…Дискусія щодо місця гіпофракціонування в променевому лікуванні нейроонкологічних пацієнтів триває. Про це свідчать недавно опубліковані системні огляди та метааналізи [10][11][12][13][14][15].…”

Section: аналіз співвідношення ризику смерті та прогресування залежно...unclassified

Hypofractionated radiotherapy of patients with glioblastoma: the first experience in Ukraine and prospects view

Gryazov¹,

Glavatskyi²,

Chuvashova³

et al. 2023

Ukr Neurosurg J

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Objective: To assess the survival of patients (pts) with newly diagnosed glioblastoma (GBM) in groups with hypofractionated regime radiotherapy, standard fractionationated regime radiotherapy and whole brain irradiation.Materials and methods: A retrospective non-randomized single-center study of 205 pts with GBM grade 4 according to the WHO classification treated in Romodanov Neurosurgery Institute named after Acad. A.P. Romodanov National Academy of Medical Science of Ukraine (2014–2020). The mean age of pts 53.8 years (95% CI 52.1 - 55.5); there were 114 men (55.6%) and 91 women (44.4%). According to the regimen radiotherapy (RT), pts were divided into 3 groups: 49 (23.9%) pts (standard RT: 2.0 Gy per fraction in 30 fractions, total dose 60.0 Gy) – group "sRT", 110 (53.7%) pts (hypofractionated RT: 3.5 Gy per fraction in 15 fractions, total dose 52, 5 Gy) - group "hRT", 46 (22.4%) pts – group "WBRT" (whole brain radiation). Differences in progression-free survival (PFS) and overall survival (OS) between the three groups were analyzed using Kaplan–Meier survival curve, log-rank test and Pearson Chi-square test.Results: The median OS is 15,0 (95% CI 14,1 – 17,1), 16,5 (95% CI 14,1 – 18,8) and 8,7 (95% CІ 7,5 – 9,5) months for sRT, hRT and WBRT, respectively. There is a significant difference in OS for sRT and hRT compared to WBRT (p=0.00000), without difference in OS between sRT and hRT (p=0.06757). The median PFS in sRT and hRT does not differ significantly: sRT – 9.0 (95% CI 9.0 - 10.0) months; hRT – 9.0 (95% CI 8.0 - 10.0) months. The median OS for WBRT is 5.1 (95% CI 4.0 - 6.0) months. There is a significant difference in PFS for sRT and hRT compared to the WBRT (p=0.00000), without difference in PFS between sRT and hRT (p=0.43374). The risk of death for WBRT compared to sRT is 2.5 times higher (HR 2.5 [95% CI, 1.45 - 4.46)) and 3.5 times higher compared to the hRT group (HR 3.5 [95% CI, 2.09-5.88)). The risk of progression for WBRT is 2.8 times higher (HR 2.78 [95% CI, 1.63-4.74)) compared to sRT, and 3.1 times higher (HR 3.12 [95% CI, 1.91-5.10)) compared to hRT.The broad implementation of hRT into clinical practice is specific to all modern radiation oncology. This trend is currently underway due to the specific positive clinical effects of hRT, which are discussed in detail in our publication.Conclusions: Our study demonstrates comparable survival outcome between sRT and hRT groups. This is an argument in favor of the feasibility of using hRT as a part of multimodal GBM treatment in terms of oncological outcomes. Further studies are needed to identify specific stratification groups of GMB patients with the greatest survival and quality of life benefits due to hRT.

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Comparative analysis of hypofractionated short-course versus standard radiation therapy in elderly patients with glioblastoma: analysis of nationwide database

Won,

Kim,

et al. 2024

J Neurooncol

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Hypofractionated radiotherapy for newly diagnosed elderly glioblastoma patients: A systematic review and network meta-analysis

Cited by 10 publications

References 33 publications

Optimal managements of elderly patients with glioblastoma

Optimal managements of elderly patients with glioblastoma

Hypofractionated radiotherapy of patients with glioblastoma: the first experience in Ukraine and prospects view

Comparative analysis of hypofractionated short-course versus standard radiation therapy in elderly patients with glioblastoma: analysis of nationwide database

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