Hypofractionated radiotherapy with temozolomide in diffuse intrinsic pontine gliomas: a randomized controlled trial

Izzuddeen, Yousra; Gupta, Seema; Haresh, K.P.; Sharma, Dayanand; Giridhar, Prashanth; Rath, Gour Kishore

doi:10.1007/s11060-019-03340-7

Cited by 22 publications

(35 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, the meta-analysis ultimately included data from 4 articles (Table 1 ). [ 10 , 11 , 7 , 8 ] Two studies were randomized controlled trials [ 11 , 8 ] and 2 were retrospective studies, [ 10 , 7 ] that included one matched cohort analysis. [ 7 ] The eligible reports were published during 2013 to 2020.…”

Section: Resultsmentioning

confidence: 99%

“…Janssens et al [ 7 ] reported that HFRT had a significant shorter median treatment time than CFRT (20 days vs 41 days, P < .01). Three reports described toxicity-related data, [ 11 , 7 , 8 ] albeit with very different criteria. The only reported grade 3 toxicity involved a single case of subdural hemorrhage in the CFRT plus temozolomide arm from the study by Izzuddeen et al [ 11 ] There were no statistically significant differences in grades 1 and 2 toxicities from the other 2 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Zaghloul et al [ 8 ] reported various acute toxicities in the 2 groups, which included skin reactions, hearing issues, decreased appetite, dysphagia, fatigue, insomnia, nightmares, and seizure, although there were no significant differences between the HFRT and CFRT groups. Other studies [ 10 , 11 , 7 ] failed to identify any grade 3–4 radiotherapy-related acute toxicities in patients who underwent HFRT, and the HFRT and CFRT strategies appeared to provide a similar efficacy. Zaghloul et al [ 8 ] evaluated steroid discontinuation, which occurred in 6 HFRT cases and 5 CFRT cases, and also noted that the HFRT group exhibited significant improvements in neurologic conditions (cranial nerve disorders and ataxia).…”

Section: Discussionmentioning

confidence: 97%

“…Moreover, the differences in the 18-month rates were only 2.2% for OS and 1.2% for PFS, with CI values (–21–25% for OS and –20–22% for PFS) that substantially exceeded the required non-inferiority margin (20%). A second phase II randomized controlled trial was performed by Izzuddeen et al, [ 11 ] which only included 35 patients. This is likely related to the difficulty in enrolling a large sample of patients, given the low incidence of DIPG.…”

Section: Discussionmentioning

confidence: 99%

“…[ 7 , 8 ] However, 2 related reports were published in 2020, which facilitated our meta-analysis of the outcomes after HFRT and CFRT. [ 10 , 11 ]…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Hypofractionated radiotherapy versus conventional radiotherapy for diffuse intrinsic pontine glioma

Park

Yea²

2020

Medicine

View full text Add to dashboard Cite

Background: The standard treatment for diffuse intrinsic pontine glioma (DIPG) is radiotherapy, although conventional fractionated radiotherapy (CFRT) may not be in the best interest of the patient. Instead, hypofractionated radiotherapy (HFRT) may shorten the treatment period and reduce related costs for this treatment, which is typically palliative in nature. Methods: This systematic review and meta-analysis evaluated survival outcomes among patients who received HFRT or CFRT for DIPG. The PubMed, Medline, EMBASE, Cochrane Central Register, and Scopus databases were searched to identify relevant studies. Overall survival was the primary outcome of interest and progression-free survival was the secondary outcome of interest. Results: The search identified a total of 2376 reports, although only 4 reports were ultimately included in the meta-analysis. The studies included 88 patients who underwent HFRT and 96 patients who underwent CFRT. Relative to CFRT, HFRT provided comparable outcomes in terms of overall survival (hazard ratio [HR]: 1.07, 95% confidence interval [CI]: 0.77–1.47) and progression-free survival (HR: 1.04, 95% CI: 0.75–1.45). Conclusions: The results of this meta-analysis suggest that CFRT and HFRT provide similar survival outcomes for patients with DIPG.

show abstract