Hypofractionated Radiation Therapy with Temozolomide for Patients with Glioblastoma Multiforme Recursive Partitioning Analyzes Class V and VI

Abstract

INTRODUCTION[|]This study was performed to determine whether adjuvant temozolomide and 45 Gy/15 fr hypofractionated radiotherapy (RT) can be used to shorten the treatment duration in glioblastoma multiforme (GBM) patients with poor prognostic factors (Recursive Partitioning Analyzes (RPA) categories V, VI), without increasing the dose and toxicity and without risking the survival.[¤]METHODS[|]Patients older than 50 years, with histological diagnosis of GBM, who were in either RPA class V or VI were included in this retrospective single-arm single-center study. Patients were treated with a tumor dose of 45 Gy in 15 daily fractions in 15 treatment days in three weeks, together with concomitant temozolomide and adjuvant temozolomide.[¤]RESULTS[|]A total of 43 patients were included in this study. RT was completed as planned in full dose in all patients. No grade 3 acute toxicity due to hypofractionated RT was observed. Concomitant temozolomide was also used in all patients without dose lowering while adjuvant temozolomide as six cycles was applied in 27 patients, but in 12 of them, temozolomide dose was lowered due to hematological toxicity. Median overall survival was found as 10.5 months, and 1-year overall survival proportion was 42%. The median progression-free survival time was 8.4 months.[¤]DISCUSSION AND CONCLUSION[|]While no decrease in expected survival with hypofractionated radiotherapy and temozolomide was detected, no increase in toxicity was observed.[¤]

Keywords

• glioblastoma multiforme
• hypofraction; radiation therapy; temozolomide.