Journal article
Hypofractionated Stereotactic Radiation Therapy: An Effective Therapy for Recurrent High-Grade Gliomas
Journal of clinical oncology, v 28(18), pp 3048-3053
20 Jun 2010
PMID: 20479391
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose
Salvage options for recurrent high-grade gliomas (HGGs) are limited by cumulative toxicity and limited efficacy despite advances in chemotherapeutic and radiotherapeutic techniques. Previous studies have reported encouraging survival results and favorable toxicity with fractionated stereotactic radiotherapy, and small studies have shown similar benefit using a shortened course of hypofractionated stereotactic radiation therapy (H-SRT). We sought to determine the efficacy and toxicity profile of H-SRT alone or in addition to repeat craniotomy or concomitant chemotherapy.
Patients and Methods
Between 1994 and 2008, 147 patients with recurrent HGG were treated with H-SRT (median dose, 35 Gy in 3.5-Gy fractions). Cox regression models were used to analyze survival outcomes. Variables included age, surgery before H-SRT, time to first recurrence, reirradiation dose, inclusion of chemotherapy with H-SRT, and gross tumor volume (GTV).
Results
Younger age (P = .001), smaller GTV (P = .025), and shorter time between diagnosis and recurrence (P = .034) were associated with improvement in survival from H-SRT. Doses of radiation ≥ 35 Gy approached significance (P = .07). There was no significant benefit of surgical resection or chemotherapy in this population when analysis was controlled for other prognostic factors.
Conclusion
H-SRT was well tolerated and resulted in a median survival time of 11 months after H-SRT, independent of re-operation or concomitant chemotherapy. Patients who experienced recurrence within 6 months after initial treatment had an excellent response and should not be disqualified from H-SRT. This is the largest series to examine the efficacy and tolerability of H-SRT in recurrent HGG.
Metrics
Details
- Title
- Hypofractionated Stereotactic Radiation Therapy: An Effective Therapy for Recurrent High-Grade Gliomas
- Creators
- Shannon E. Fogh - Thomas Jefferson UniversityDavid W. Andrews - Thomas Jefferson UniversityJon Glass - Thomas Jefferson UniversityWalter Curran - Thomas Jefferson UniversityCharles Glass - Neurological SurgeryColin Champ - Thomas Jefferson UniversityJames J. Evans - Thomas Jefferson UniversityTerry Hyslop - Thomas Jefferson UniversityEdward Pequignot - Thomas Jefferson UniversityBeverly Downes - Thomas Jefferson UniversityEileen Comber - Thomas Jefferson UniversityMitchell Maltenfort - Thomas Jefferson UniversityAdam P. Dicker - Thomas Jefferson UniversityMaria Werner-Wasik
- Publication Details
- Journal of clinical oncology, v 28(18), pp 3048-3053
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000278883200020
- Scopus ID
- 2-s2.0-77954600194
- Other Identifier
- 991021897259804721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology