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Evaluating the Role of Hypofractionated Radiotherapy Schedule in High Grade Glioma Patients Less Than 60 Years of Age
Sheel Mohanty1, Anshul Singh, N P Jayashree
1Department of Radiation Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.
Background:
The aim of the study was to evaluate the role of hypofractionated radiotherapy (HRT) in patients with the high-grade gliomas (HGG) aged less than 60 years that would decrease the patient's hospital stay, while offering similar Progression free survival.
Materials And Methods:
This is a prospective observation study and the HGG patients less than 60 years of age were eligible for the study. All patients underwent HRT regimen of 40 Gray (Gy) in 15 daily fractions with concurrent and adjuvant Temozolomide (TMZ) for at least six cycles. The Primary objective was to assess the progression free survival (PFS), while overall survival (OS) and toxicity profile being secondary end points.
Results:
From April 2021 to April 2022, 15 patients were recruited in the study. The mean age was 44.6 years, 14 of our patients were less than 50 years of age. Five of our patients had more than one lobe, involved with seven patients had a midline shift. IDH wild type was seen in 10 patients. Most patients (Nine patients) underwent a gross tumor excision. The median follow-up was 15 months (Range of 7-19 months). The estimated median PFS was 13.5 months (SD ± 1.13; 95% CI 11.23-15.66). On multivariate analysis, only male gender and presence of midline shift were found to affect negatively the PFS. Three patients had disease progression at last follow-up.
Conclusion:
The HRT regimen can be an alternative to the long course chemoradiation regimen with acceptable PFS and toxicity in patients less than 60 years of age.
