The results of hypofractionated radiotherapy in 31 patients with high-grade gliomas

Abstract

In this prospective study, we investigated the effects of hypofractionated radiotherapy for patients with high-grade gliomas. About 31 patients with glioblastoma multiforme or anaplastic astrocytoma were studied between October 2003 and December 2004. Hypofractionated radiotherapy (3 Gy/fraction/day) was delivered to a total dose of 45 Gy in 15 fractions in 10 patients (32%) who had total excision before radiotherapy and to a total dose of 54 Gy in 18 fractions in 21 patients (68%) who had subtotal excision or biopsy alone. Sex, age, type of surgery, tumor grade, Karnofsky performance status, time between surgery and initiation of radiotherapy, and total radiotherapy dose were analyzed as potential prognostic factors for survival using the univariate log-rank method. The median follow-up was 15 months (4-16 months). A total of 15 patients (48%) died of their illness; 16 patients (52%) were still alive at the last follow-up. The median survival time was 8 months. Actuarial 1-year overall survival was 40%. Type of surgery, timing of radiotherapy after surgery, and initial Karnofsky performance status were significant prognostic factors for survival. No grade 3-4 acute or late neurotoxicity was observed. The tolerance of patients to hypofractionated RT was not different from that for conventional radiotherapy. This treatment schedule can be used for patients with high-grade gliomas. Future investigations are needed to determine the optimal fractionation for high-grade gliomas.

Hypofractionated radiotherapy for glioblastoma: strategy for poor-risk patients or hope for the future?

“…Sayin et al [24] reported on a prospective series of 31 patients with malignant glioma who were treated with HFRT using 45 Gy in 15 fractions after GTR (n510) or a dose of 54 Gy in 18 fractions after STR (n520). The MS was 8 months with an actuarial 1 year survival of 40%.…”

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

“…[8,11] Toward this end, hypoRT has emerged as an attractive option in terms of reducing the OTT as well as number of hospital visits by the patients and their care-givers. The outcomes with hypoRT regimens [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] have been comparable and not inferior to protracted conventionally fractionated schedules [ Table 3]. The optimal fractionation regimen of hypoRT is not yet clearly defined with diverse fractionation schedules prevalent worldwide [ Table 3].…”

The Role of Radiotherapy and Chemotherapy in the Treatment of Primary Adult High Grade Gliomas: Assessment of Patients for These Treatment Approaches and the Common Immediate Side Effects

“…This regimen is used not only in older age but also in patients with poor prognosis and unresectable tumours [19]. Hypofractionation showed glioblastoma patients to have a favourable response in terms of survival rate over the conventional fractionation [26] while other studies concluded that hypofractionation had similar results and tolerance comparable with conventional fractionation [27, 28]. …”