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PET and MRI Guided Irradiation of a Glioblastoma Rat Model Using a Micro-irradiator
Published on: December 28, 2017
Identification of Patients With Glioblastoma Who May Benefit from Hypofractionated Radiotherapy
Oksana Zemskova1,2, Nathan Y Yu3, Peter Trillenberg4
1Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Background/Aim:
Standard radiotherapy (RT) for glioblastoma lasts 6 weeks. We aimed to identify patients who would benefit from a hypofractionated approach.
Patients And Methods:
In 167 patients receiving standard fractionation, 10 factors were analyzed for local control (LC) and overall survival (OS). A survival score was developed and compared to a previous instrument.
Results:
On multivariate analysis, better LC was significantly associated with the presence of only one lesion and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation. Better OS was associated with one lesion, better performance status, MGMT promoter methylation, and receipt of chemotherapy. Lesion diameter ≤40 mm and upfront resection were associated with improved OS on univariate analyses. Based on assigning scores to these six factors, three groups, with 32-35, 36-44 and 45-48 points, were designed with 12-month OS-rates of 0%, 56%, and 92%, respectively. Accuracy in predicting death within 12 months and survival ≥12 months was 100% and 92%, respectively, versus 67% and 83% with the previous scoring system.
Conclusion:
A new survival score with higher accuracy was developed for patients with glioblastoma. Our model can be utilized to individualize RT dose-fractionation recommendations for glioblastoma.
