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Published on: October 27, 2014
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Accelerated hyperfractionation plus temozolomide in glioblastoma.
David Kaul1, Julian Florange2, Harun Badakhshi2
1Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. david.kaul@charite.de.
Radiation Oncology (London, England)
|May 23, 2016
Summary
Accelerated hyperfractionated radiotherapy (AHFRT) combined with Temozolomide (TMZ) did not significantly improve progression-free survival or overall survival for glioblastoma patients compared to standard normofractionated radiotherapy (NFRT). Further trials are recommended.
Area of Science:
- Radiation Oncology
- Neuro-oncology
- Clinical Cancer Research
Background:
- Hyperfractionated radiotherapy (HFRT) and accelerated hyperfractionated radiotherapy (AHFRT) were explored for glioblastoma to reduce radiation injury and prevent tumor repopulation.
- Previous studies in the pre-Temozolomide era yielded inconclusive results regarding the efficacy of HFRT and AHFRT.
- This study investigates the role of AHFRT within the current standard of care, which includes Temozolomide (TMZ).
Purpose of the Study:
- To evaluate the efficacy of accelerated hyperfractionated radiotherapy (AHFRT) compared to normofractionated radiotherapy (NFRT) in glioblastoma patients treated with Temozolomide (TMZ).
- To assess the impact of different radiotherapy fractionation regimens on progression-free survival (PFS) and overall survival (OS).
Main Methods:
- A retrospective analysis compared 64 patients treated with AHFRT (62 receiving TMZ) to 67 patients treated with NFRT (64 receiving TMZ).
- Patient data were collected between February 2009 and October 2014, with follow-up until January 2015.
- Progression-free survival (PFS), overall survival (OS), and acute toxicity were analyzed.
Main Results:
- Median PFS was 6 months for the entire cohort, with no significant difference between AHFRT (6 months) and NFRT (7 months).
- Median OS was 13 months for the entire cohort, with NFRT showing a median OS of 15 months versus 10 months for AHFRT.
- Radiotherapy fractionation regimen was not a predictor of PFS or OS in univariable or multivariable analyses, and acute toxicity profiles were similar between groups.
Conclusions:
- No significant differences in PFS or OS were observed between NFRT and AHFRT fractionation regimens in glioblastoma patients treated with TMZ.
- AHFRT significantly shortens hospitalization time in patients with a poor prognosis.
- The potential role of AHFRT combined with TMZ warrants further investigation in prospective clinical trials.
