Increasing radiation dose intensity using hyperfractionation in patients with malignant glioma

Fulton, D.; Urtasun, Raul C.; Scott-Brown, I.; Johnson, Edward S.; Mielke, Bruce; Curry, Bernadette; Huyser-Wierenga, D; Hanson, John; Feldstein, Michael

doi:10.1007/bf00170946

Cited by 60 publications

(14 citation statements)

References 22 publications

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“…Hyperfractionated radiotherapy, in which more than one fraction of radiation is administered daily, typically with a lower dose per fraction, has not proven to improve outcomes nor decrease associated side effects of radiation. 34,35 Chemotherapy Following surgical resection, chemotherapy is started usually in combination with radiation therapy, although it is often continued as maintenance therapy. For children younger than 3 years, chemotherapy can be administered as a primary therapy to delay radiation as long as possible.…”

Section: Radiation Therapymentioning

confidence: 99%

High-Grade Gliomas in Children

Cage¹,

Mueller²,

Haas‐Kogan³

et al. 2012

Neurosurgery Clinics of North America

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High-grade gliomas (HGGs) are malignant tumors and typically include glioblastoma multiforme and anaplastic astrocytoma subtypes. Brainstem gliomas and ependymomas are separate entities with respect to clinical presentation, treatment, prognosis, and outcome in comparison with supratentorial HGGs. In children, these tumors account for 3% to 7% of newly diagnosed brain tumors and 20% of all diagnoses of pediatric supratentorial brain tumors. These neoplasms are highly proliferative and mitotically active and of glial origin. This article reviews clinical, diagnostic, and pathologic features of HGG and current treatments and potential future therapies specific to pediatric patients with HGGs.

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Section: Radiation Therapymentioning

confidence: 99%

High-Grade Gliomas in Children

Cage¹,

Mueller²,

Haas‐Kogan³

et al. 2012

Neurosurgery Clinics of North America

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“…Higher radiation doses (to a cumulative total dose of 72 Gy) in conjunction with hyperfractionation have failed to improve outcome for patients with high-grade gliomas. 86 …”

Section: Radiationmentioning

confidence: 99%

Pediatric Brain Tumors: Current Treatment Strategies and Future Therapeutic Approaches

2009

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Summary:Pediatric CNS tumors are the most common solid tumors of childhood and the second most common cancer after hematological malignancies accounting for approximate 20 to 25% of all primary pediatric tumors. With over 3,000 new cases per year in the United States, childhood CNS tumors are the leading cause of death related to cancer in this population. The prognosis for these patients has improved over the last few decades, but current therapies continue to carry a high risk of significant side effects, especially for the very young. Currently a combination of surgery, radiation, and chemotherapy is often used in children greater than 3 years of age. This article will outline current and future therapeutic strategies for the most common pediatric CNS tumors, including primitive neuroectodermal tumors such as medulloblastoma, as well as astrocytomas and ependymomas.

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“…The addition of misonidazole did not alter the survival significantly as compared with accelerated RT alone. From 1984, the authors stopped accrual to the conventional and the AHF-RT plus misonidazole arms, and subsequently all eligible patients were being randomized [30] to AHF-RT as above or high-dose AHF-RT (71.2 Gy/80 fractions/5.5 weeks using 3 fraction daily of 0.89 Gy each).…”

Section: Literature Search Strategy Gymentioning

confidence: 99%

Modified optimal fractionation for poor prognosis malignant gliomas: An elusive search

Gupta

Dinshaw

2005

Acta Oncologica

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The prognosis of malignant gliomas has not changed much over the last few decades despite refinements in neurosurgical techniques, high-precision radiotherapy, and newer chemotherapeutic agents. The median survival of poor prognosis malignant gliomas (older and/or poor performance status patients) still remains in the range of 6 Á/9 months following maximal safe resection and postoperative conventionally fractionated adjuvant radiotherapy with or without chemotherapy. However, six weeks of daily radiotherapy does seem inappropriate in relation to the short expected survival time in this subset and there is an increasing emphasis on reducing the overall treatment time and the number of hospital visits by such patients. This can be achieved either by accelerated radiotherapy or by hypofractionated radiation, both of which are equivalent to conventional fractionation in terms of palliative effect and survival, as in discussed in this review. Despite enough evidence, such alteration of fractionation has not gained widespread acceptance by the oncologic fraternity. This review has been conducted to collate the evidence that could help shift the paradigm from conventional to modified fractionation in poor prognosis malignant glioma patients.

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Increasing radiation dose intensity using hyperfractionation in patients with malignant glioma

Cited by 60 publications

References 22 publications

High-Grade Gliomas in Children

High-Grade Gliomas in Children

Pediatric Brain Tumors: Current Treatment Strategies and Future Therapeutic Approaches

Modified optimal fractionation for poor prognosis malignant gliomas: An elusive search

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