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Related Experiment Videos

Accelerated hyperfractionated radiation therapy for malignant glioma. A phase II study

B Jeremic1, D Grujicic, V Antunovic

  • 1Department of Oncology, University Hospital, Kragujevac, Yugoslavia.

American Journal of Clinical Oncology
|October 1, 1995
PubMed
Summary

Accelerated hyperfractionated radiation therapy combined with chemotherapy shows promise for malignant glioma patients. While glioblastoma multiforme patients had limited progression-free survival, anaplastic astrocytoma patients showed excellent long-term outcomes.

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[Not Available].

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]·2016

Area of Science:

  • Neuro-oncology
  • Radiation Oncology
  • Clinical Oncology

Background:

  • Malignant gliomas, including anaplastic astrocytoma (AA) and glioblastoma multiforme (GBM), are aggressive brain tumors.
  • Standard treatment protocols often involve surgery, radiation, and chemotherapy, but outcomes remain challenging.
  • Optimizing radiation therapy schedules, such as accelerated hyperfractionation, is crucial for improving patient survival.

Purpose of the Study:

  • To evaluate the efficacy and toxicity of accelerated hyperfractionated radiation therapy in adult patients with malignant glioma.
  • To assess the impact of combined chemotherapy (BCNU and hydroxyurea) on treatment outcomes.
  • To identify prognostic factors influencing survival and tumor progression in this patient cohort.

Main Methods:

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  • A Phase II study involving 64 adult patients with malignant glioma (15 AA, 49 GBM).
  • Treatment included accelerated hyperfractionated radiation therapy (66 Gy in 44 fractions over 4.5 weeks, 1.5 Gy per fraction, b.i.d.).
  • Concomitant chemotherapy with BCNU and hydroxyurea was administered on specific days during irradiation.

    • Main Results:

    • Median survival for all patients was 61 weeks.
    • For GBM patients, median time to tumor progression (MTP) was 31 weeks, with 1- and 3-year progression-free survival (PFS) of 16% and 0%, respectively.
    • For AA patients, MTP was not attained, with 1- and 3-year PFS of 100% and 73%, respectively.
    • Univariate and multivariate analyses identified younger age, extent of surgery, tumor location, and interfraction interval as significant prognostic factors for GBM.
    • Acute and late toxicity were not increased.

    Conclusions:

    • Accelerated hyperfractionated radiation therapy with BCNU and hydroxyurea demonstrates potential efficacy, particularly in anaplastic astrocytoma patients.
    • Prognostic factors such as surgical extent and tumor site significantly impact outcomes in glioblastoma multiforme.
    • Further investigation with longer follow-up and larger patient cohorts is warranted to fully assess tumor control and toxicity, especially in AA patients.