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Accelerated hyperfractionated radiotherapy in supratentorial malignant astrocytomas
M Genc1, A F Zorlu, I L Atahan
1Department of Radiation Oncology, University of Selcuk, Faculty of Medicine, Konya, Turkey.
Summary
Accelerated hyperfractionated radiotherapy for malignant astrocytomas shortened treatment to 3 weeks but did not improve survival. This radiotherapy approach was well-tolerated with acceptable late toxicity.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Clinical Trials
Background:
- Malignant astrocytomas, including anaplastic astrocytoma (AA) and glioblastoma multiforme (GBM), are aggressive brain tumors.
- Standard radiotherapy regimens for these tumors are lengthy, posing challenges for patient tolerance and treatment completion.
Purpose of the Study:
- To evaluate the safety and effectiveness of accelerated hyperfractionated radiotherapy in treating supratentorial malignant astrocytomas.
- To assess if a shortened treatment schedule impacts patient outcomes and toxicity.
Main Methods:
- A prospective phase II study enrolled 75 patients with supratentorial malignant astrocytomas.
- A total dose of 60 Gy was delivered in 2 Gy twice-daily fractions over 3 weeks.
- Treatment planning involved dose escalation to contrast-enhancing lesions and surrounding edema based on MRI/CT findings.
Main Results:
- Median survival was 11 months overall (10 months for GBM, 40 months for AA).
- 1-year and 3-year survival rates were 41% and 11% for all patients.
- Grade 3 or worse late neurological toxicity occurred in 5.3% of patients.
Conclusions:
- Accelerated hyperfractionated radiotherapy significantly reduced the treatment duration from 6 to 3 weeks.
- While not improving survival, the regimen was well-tolerated with an acceptable incidence of late toxicity.
- Age, histology, and neurological function were significant predictors of survival.