Clinical Studies on Ultrafractionated Chemoradiation: A Systematic Review
AimThe efficacy of low-dose fractionated radiotherapy (LDFRT) and chemotherapy (CHT) combination has large preclinical but little clinical evidence. Therefore, the aim of this review was to collect and analyze the clinical results of LDRT plus concurrent CHT in patients with advanced cancers.Methods...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:0f77888cecc14faa9db3b90d2d7aa2302021-11-16T07:22:37ZClinical Studies on Ultrafractionated Chemoradiation: A Systematic Review2234-943X10.3389/fonc.2021.748200https://doaj.org/article/0f77888cecc14faa9db3b90d2d7aa2302021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.748200/fullhttps://doaj.org/toc/2234-943XAimThe efficacy of low-dose fractionated radiotherapy (LDFRT) and chemotherapy (CHT) combination has large preclinical but little clinical evidence. Therefore, the aim of this review was to collect and analyze the clinical results of LDRT plus concurrent CHT in patients with advanced cancers.MethodsA systematic literature search was conducted on PubMed using the PRISMA methodology. Only studies based on the combination of LDFRT (< 1 Gy/fraction) and CHT were included. Endpoints of the analysis were tumor response, toxicity, and overall survival, with particular focus on any differences between LDFRT-CHT and CHT alone.ResultsTwelve studies (307 patients) fulfilled the selection criteria and were included in this review. Two studies were retrospective, one was a prospective pilot trial, six were phase II studies, two were phase I trials, and one was a phase I/II open label study. No randomized controlled trials were found. Seven out of eight studies comparing clinical response showed higher rates after LDFRT-CHT compared to CHT alone. Three out of four studies comparing survival reported improved results after combined treatment. Three studies compared toxicity of CHT and LDFRT plus CHT, and all of them reported similar adverse events rates. In most cases, toxicity was manageable with only three likely LDFRT-unrelated fatal events (1%), all recorded in the same series on LDFRT plus temozolomide in glioblastoma multiforme patients.ConclusionNone of the analyzed studies provided level I evidence on the clinical impact of LDFRT plus CHT. However, it should be noted that, apart from two small series of breast cancers, all studies reported improved therapeutic outcomes and similar tolerability compared to CHT alone. Systematic Review Registrationwww.crd.york.ac.uk/prospero/, identifier CRD42020206639.Erica SciroccoErica SciroccoFrancesco CelliniFrancesco CelliniAlice ZamagniAlice ZamagniGabriella MacchiaFrancesco DeodatoSavino CillaLidia StrigariMilly BuwengeStefania RizzoSilvia CammelliSilvia CammelliAlessio Giuseppe MorgantiAlessio Giuseppe MorgantiFrontiers Media S.A.articlechemo-sensitizationlow-dose radiotherapysystematic reviewclinical trialscombined modality treatmentNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021) |
| institution |
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| collection |
DOAJ |
| language |
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| topic |
chemo-sensitization low-dose radiotherapy systematic review clinical trials combined modality treatment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
| spellingShingle |
chemo-sensitization low-dose radiotherapy systematic review clinical trials combined modality treatment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Erica Scirocco Erica Scirocco Francesco Cellini Francesco Cellini Alice Zamagni Alice Zamagni Gabriella Macchia Francesco Deodato Savino Cilla Lidia Strigari Milly Buwenge Stefania Rizzo Silvia Cammelli Silvia Cammelli Alessio Giuseppe Morganti Alessio Giuseppe Morganti Clinical Studies on Ultrafractionated Chemoradiation: A Systematic Review |
| description |
AimThe efficacy of low-dose fractionated radiotherapy (LDFRT) and chemotherapy (CHT) combination has large preclinical but little clinical evidence. Therefore, the aim of this review was to collect and analyze the clinical results of LDRT plus concurrent CHT in patients with advanced cancers.MethodsA systematic literature search was conducted on PubMed using the PRISMA methodology. Only studies based on the combination of LDFRT (< 1 Gy/fraction) and CHT were included. Endpoints of the analysis were tumor response, toxicity, and overall survival, with particular focus on any differences between LDFRT-CHT and CHT alone.ResultsTwelve studies (307 patients) fulfilled the selection criteria and were included in this review. Two studies were retrospective, one was a prospective pilot trial, six were phase II studies, two were phase I trials, and one was a phase I/II open label study. No randomized controlled trials were found. Seven out of eight studies comparing clinical response showed higher rates after LDFRT-CHT compared to CHT alone. Three out of four studies comparing survival reported improved results after combined treatment. Three studies compared toxicity of CHT and LDFRT plus CHT, and all of them reported similar adverse events rates. In most cases, toxicity was manageable with only three likely LDFRT-unrelated fatal events (1%), all recorded in the same series on LDFRT plus temozolomide in glioblastoma multiforme patients.ConclusionNone of the analyzed studies provided level I evidence on the clinical impact of LDFRT plus CHT. However, it should be noted that, apart from two small series of breast cancers, all studies reported improved therapeutic outcomes and similar tolerability compared to CHT alone. Systematic Review Registrationwww.crd.york.ac.uk/prospero/, identifier CRD42020206639. |
| format |
article |
| author |
Erica Scirocco Erica Scirocco Francesco Cellini Francesco Cellini Alice Zamagni Alice Zamagni Gabriella Macchia Francesco Deodato Savino Cilla Lidia Strigari Milly Buwenge Stefania Rizzo Silvia Cammelli Silvia Cammelli Alessio Giuseppe Morganti Alessio Giuseppe Morganti |
| author_facet |
Erica Scirocco Erica Scirocco Francesco Cellini Francesco Cellini Alice Zamagni Alice Zamagni Gabriella Macchia Francesco Deodato Savino Cilla Lidia Strigari Milly Buwenge Stefania Rizzo Silvia Cammelli Silvia Cammelli Alessio Giuseppe Morganti Alessio Giuseppe Morganti |
| author_sort |
Erica Scirocco |
| title |
Clinical Studies on Ultrafractionated Chemoradiation: A Systematic Review |
| title_short |
Clinical Studies on Ultrafractionated Chemoradiation: A Systematic Review |
| title_full |
Clinical Studies on Ultrafractionated Chemoradiation: A Systematic Review |
| title_fullStr |
Clinical Studies on Ultrafractionated Chemoradiation: A Systematic Review |
| title_full_unstemmed |
Clinical Studies on Ultrafractionated Chemoradiation: A Systematic Review |
| title_sort |
clinical studies on ultrafractionated chemoradiation: a systematic review |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/0f77888cecc14faa9db3b90d2d7aa230 |
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