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Hypo-fractionated Radiotherapy (HF-RT) Versus Conventionally Fractionated Radiotherapy (CF-RT) for Glioblastoma.
Oksana Zemskova1,2, Eugene Pedachenko2, Nathan Y Yu3
1Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Anticancer Research
|June 23, 2023
Summary
Conventional fractionation radiotherapy (CF-RT) showed better local control and overall survival than hypo-fractionated radiotherapy (HF-RT) in glioblastoma patients, especially those with poorer performance status or unifocal tumors.
Area of Science:
- Radiation Oncology
- Neuro-oncology
- Clinical Cancer Research
Background:
- Hypo-fractionated radiotherapy (HF-RT) is increasingly adopted for glioblastoma (GBM) patients, particularly the elderly and frail.
- Limited radiotherapy resources in some regions drive the wider application of HF-RT.
- This study enables a comparison between conventional fractionation radiotherapy (CF-RT) and HF-RT across diverse patient populations.
Purpose of the Study:
- To compare the efficacy of conventional fractionation radiotherapy (CF-RT) versus hypo-fractionated radiotherapy (HF-RT) in glioblastoma patients.
- To evaluate local control (LC) and overall survival (OS) outcomes for both treatment modalities.
- To identify patient subgroups that may benefit differentially from CF-RT or HF-RT.
Main Methods:
- Retrospective analysis of 277 glioblastoma patients.
- Comparison between 110 patients receiving HF-RT (52.5 Gy in 15 fractions) and 167 patients receiving CF-RT (54.0-60.0 Gy in 27-33 fractions).
- Analysis included univariable and multivariable assessments, considering patient characteristics like Karnofsky Performance Status (KPS), tumor status, age, and treatment details.
Main Results:
- CF-RT was associated with significantly better local control (LC) and overall survival (OS) in patients with KPS ≤70 and unifocal glioblastoma.
- CF-RT also showed improved OS in the entire cohort and trends towards better LC and OS in patients younger than 60 years.
- Multivariable analysis confirmed that CF-RT, higher KPS (80-100), unifocal tumors, tumor resection, and chemotherapy were significantly associated with improved LC and OS.
Conclusions:
- Conventional fractionation radiotherapy (CF-RT) appears to be associated with superior outcomes in glioblastoma patients.
- Hypo-fractionated radiotherapy (HF-RT) may be a beneficial option for selected patient groups.
- Further research is warranted to refine treatment strategies based on patient-specific factors.
