Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide

Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide

Background: Glioblastoma (GBM) is a very poor-prognosis brain tumor. To date, maximal excision followed by radiochemotherapy, in 30 fractions, is the standard approach. Limited data are present in the literature about hypofractionated radiotherapy (hypo-RT) in GBM poor prognosis patients. Thus, this...

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Autores principales: Fabiana Gregucci, Alessia Surgo, Ilaria Bonaparte, Letizia Laera, Maria Paola Ciliberti, Roberta Carbonara, Maria Annunziata Gentile, David Giraldi, Roberto Calbi, Morena Caliandro, Nicola Sasso, Salvatore D’Oria, Carlo Somma, Gaetano Martinelli, Giammarco Surico, Giuseppe Lombardi, Alba Fiorentino
Formato: article
Lenguaje:EN
Publicado: MDPI AG 2021
Materias:
glioblastoma
poor prognosis
radiotherapy
chemotherapy
Medicine
R
Acceso en línea:https://doaj.org/article/af3579c3dc55499992afbba282d6db59
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spelling oai:doaj.org-article:af3579c3dc55499992afbba282d6db592021-11-25T18:07:32ZPoor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide10.3390/jpm111111452075-4426https://doaj.org/article/af3579c3dc55499992afbba282d6db592021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1145https://doaj.org/toc/2075-4426Background: Glioblastoma (GBM) is a very poor-prognosis brain tumor. To date, maximal excision followed by radiochemotherapy, in 30 fractions, is the standard approach. Limited data are present in the literature about hypofractionated radiotherapy (hypo-RT) in GBM poor prognosis patients. Thus, this retrospective study was conducted to evaluate efficacy and toxicity of hypo-RT with simultaneous integrated boost (SIB) in association with temozolomide (TMZ) in this patient setting. Methods: Poor-prognosis GBM patients underwent surgery (complete, subtotal or biopsy) followed by SIB-hypo-RT and concomitant/adjuvant TMZ. The prescription dose was 40.05 Gy (15 fractions) with a SIB of 52.5 Gy (3.5 Gy/fraction) on surgical cavity/residual/macroscopic disease. Volumetric modulated arc therapy was performed. Results: From July 2019 to July 2021, 30 poor-prognosis patients affected by GBM were treated by SIB-hypo-RT; 25 were evaluated in the present analysis due to a minimum follow up of 6 months. The median age and KPS were 65 years and 60%, respectively. At the median follow-up time of 15 months (range 7–24), median and 1-year overall survival and progression-free survival were 13 months and 54%, and 8.4 months and 23%, respectively. No acute or late neurological side effects of grade ≥ 2 were reported. Grade 3–4 hematologic toxicity occurred in three cases. Conclusion: SIB-hypo-RT associated with TMZ in poor-prognosis patients affected by GBM is an effective and safe treatment. Prospective studies could be warranted.Fabiana GregucciAlessia SurgoIlaria BonaparteLetizia LaeraMaria Paola CilibertiRoberta CarbonaraMaria Annunziata GentileDavid GiraldiRoberto CalbiMorena CaliandroNicola SassoSalvatore D’OriaCarlo SommaGaetano MartinelliGiammarco SuricoGiuseppe LombardiAlba FiorentinoMDPI AGarticleglioblastomapoor prognosisradiotherapychemotherapyMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1145, p 1145 (2021)
institution DOAJ
collection DOAJ
language EN
topic glioblastoma
poor prognosis
radiotherapy
chemotherapy
Medicine
R
spellingShingle glioblastoma
poor prognosis
radiotherapy
chemotherapy
Medicine
R
Fabiana Gregucci
Alessia Surgo
Ilaria Bonaparte
Letizia Laera
Maria Paola Ciliberti
Roberta Carbonara
Maria Annunziata Gentile
David Giraldi
Roberto Calbi
Morena Caliandro
Nicola Sasso
Salvatore D’Oria
Carlo Somma
Gaetano Martinelli
Giammarco Surico
Giuseppe Lombardi
Alba Fiorentino
Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide
description Background: Glioblastoma (GBM) is a very poor-prognosis brain tumor. To date, maximal excision followed by radiochemotherapy, in 30 fractions, is the standard approach. Limited data are present in the literature about hypofractionated radiotherapy (hypo-RT) in GBM poor prognosis patients. Thus, this retrospective study was conducted to evaluate efficacy and toxicity of hypo-RT with simultaneous integrated boost (SIB) in association with temozolomide (TMZ) in this patient setting. Methods: Poor-prognosis GBM patients underwent surgery (complete, subtotal or biopsy) followed by SIB-hypo-RT and concomitant/adjuvant TMZ. The prescription dose was 40.05 Gy (15 fractions) with a SIB of 52.5 Gy (3.5 Gy/fraction) on surgical cavity/residual/macroscopic disease. Volumetric modulated arc therapy was performed. Results: From July 2019 to July 2021, 30 poor-prognosis patients affected by GBM were treated by SIB-hypo-RT; 25 were evaluated in the present analysis due to a minimum follow up of 6 months. The median age and KPS were 65 years and 60%, respectively. At the median follow-up time of 15 months (range 7–24), median and 1-year overall survival and progression-free survival were 13 months and 54%, and 8.4 months and 23%, respectively. No acute or late neurological side effects of grade ≥ 2 were reported. Grade 3–4 hematologic toxicity occurred in three cases. Conclusion: SIB-hypo-RT associated with TMZ in poor-prognosis patients affected by GBM is an effective and safe treatment. Prospective studies could be warranted.
format article
author Fabiana Gregucci
Alessia Surgo
Ilaria Bonaparte
Letizia Laera
Maria Paola Ciliberti
Roberta Carbonara
Maria Annunziata Gentile
David Giraldi
Roberto Calbi
Morena Caliandro
Nicola Sasso
Salvatore D’Oria
Carlo Somma
Gaetano Martinelli
Giammarco Surico
Giuseppe Lombardi
Alba Fiorentino
author_facet Fabiana Gregucci
Alessia Surgo
Ilaria Bonaparte
Letizia Laera
Maria Paola Ciliberti
Roberta Carbonara
Maria Annunziata Gentile
David Giraldi
Roberto Calbi
Morena Caliandro
Nicola Sasso
Salvatore D’Oria
Carlo Somma
Gaetano Martinelli
Giammarco Surico
Giuseppe Lombardi
Alba Fiorentino
author_sort Fabiana Gregucci
title Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide
title_short Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide
title_full Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide
title_fullStr Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide
title_full_unstemmed Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide
title_sort poor-prognosis patients affected by glioblastoma: retrospective study of hypofractionated radiotherapy with simultaneous integrated boost and concurrent/adjuvant temozolomide
publisher MDPI AG
publishDate 2021
url https://doaj.org/article/af3579c3dc55499992afbba282d6db59
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