Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective study
Abstract Background The prognosis of recurrent glioblastoma (GBM) is poor, with limited options of palliative localized or systemic treatments. Survival can be improved by a second localized treatment; however, it is not currently possible to identify which patients would benefit from this approach....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-022-02169-1 |
| _version_ | 1811179129659195392 |
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| author | Nicolas Demogeot J. Salleron F. Rech L. Taillandier P. Royer G. Vogin |
| author_facet | Nicolas Demogeot J. Salleron F. Rech L. Taillandier P. Royer G. Vogin |
| author_sort | Nicolas Demogeot |
| collection | DOAJ |
| description | Abstract Background The prognosis of recurrent glioblastoma (GBM) is poor, with limited options of palliative localized or systemic treatments. Survival can be improved by a second localized treatment; however, it is not currently possible to identify which patients would benefit from this approach. This study aims to evaluate which factors lead to a lower Karnofsky performance status (KPS) score after fractionated stereotactic RT (fSRT). Methods We retrospectively collected data from patients treated with fSRT for recurrent GBM at the Institut de Cancérologie de Lorraine between October 2010 and November 2017 and analyzed which factors were associated with a lower KPS score. Results 59 patients received a dose of 25 Gy in 5 sessions spread over 5–7 days (80% isodose). The median time from the end of primary radiotherapy to the initiation of fSRT was 10.7 months. The median follow-up after fSRT initiation was 8.8 months. The incidence of KPS and ADL impairment in all patients were 51.9% and 37.8% respectively with an adverse impact of PTV size on KPS (HR = 1.57 [95% CI 1.19–2.08], p = 0.028). Only two patients showed early grade 3 toxicity and none showed grade 4 or late toxicity. The median overall survival time, median overall survival time after fSRT, median progression-free survival and institutionalization-free survival times were 25.8, 8.8, 3.9 and 7.7 months, respectively. Initial surgery was associated with better progression-free survival (Hazard ratio (HR) = 0.48 [95% CI 0.27–0.86], p = 0.013). Conclusions A larger PTV should predicts lower KPS in the treatment of recurrent GBM using fSRT. |
| first_indexed | 2024-04-11T06:30:35Z |
| format | Article |
| id | doaj.art-6c9d45538ac844d780205af0278bcc7f |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-04-11T06:30:35Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-6c9d45538ac844d780205af0278bcc7f2022-12-22T04:40:06ZengBMCRadiation Oncology1748-717X2022-12-011711910.1186/s13014-022-02169-1Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective studyNicolas Demogeot0J. Salleron1F. Rech2L. Taillandier3P. Royer4G. Vogin5Academic Department of Radiation Therapy and Brachytherapy, Institut de Cancérologie de Lorraine– Alexis-Vautrin CLCC (Centre de Lutte Contre le Cancer – Cancer Center) – UnicancerDepartment of Biostatistics and Data Management, Institut de Cancérologie de LorraineDepartment of Neurosurgery, CHU de NancyDepartment of Neuro-Oncology, CHU de NancyDepartment of Radiation Oncology, Centre d’Oncologie de GentillyCentre François BaclesseAbstract Background The prognosis of recurrent glioblastoma (GBM) is poor, with limited options of palliative localized or systemic treatments. Survival can be improved by a second localized treatment; however, it is not currently possible to identify which patients would benefit from this approach. This study aims to evaluate which factors lead to a lower Karnofsky performance status (KPS) score after fractionated stereotactic RT (fSRT). Methods We retrospectively collected data from patients treated with fSRT for recurrent GBM at the Institut de Cancérologie de Lorraine between October 2010 and November 2017 and analyzed which factors were associated with a lower KPS score. Results 59 patients received a dose of 25 Gy in 5 sessions spread over 5–7 days (80% isodose). The median time from the end of primary radiotherapy to the initiation of fSRT was 10.7 months. The median follow-up after fSRT initiation was 8.8 months. The incidence of KPS and ADL impairment in all patients were 51.9% and 37.8% respectively with an adverse impact of PTV size on KPS (HR = 1.57 [95% CI 1.19–2.08], p = 0.028). Only two patients showed early grade 3 toxicity and none showed grade 4 or late toxicity. The median overall survival time, median overall survival time after fSRT, median progression-free survival and institutionalization-free survival times were 25.8, 8.8, 3.9 and 7.7 months, respectively. Initial surgery was associated with better progression-free survival (Hazard ratio (HR) = 0.48 [95% CI 0.27–0.86], p = 0.013). Conclusions A larger PTV should predicts lower KPS in the treatment of recurrent GBM using fSRT.https://doi.org/10.1186/s13014-022-02169-1GlioblastomaRecurrenceKarnofsky performance statusCyberknifeStereotactic radiotherapy |
| spellingShingle | Nicolas Demogeot J. Salleron F. Rech L. Taillandier P. Royer G. Vogin Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective study Radiation Oncology Glioblastoma Recurrence Karnofsky performance status Cyberknife Stereotactic radiotherapy |
| title | Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective study |
| title_full | Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective study |
| title_fullStr | Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective study |
| title_full_unstemmed | Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective study |
| title_short | Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective study |
| title_sort | impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive recurrent glioblastoma a retrospective study |
| topic | Glioblastoma Recurrence Karnofsky performance status Cyberknife Stereotactic radiotherapy |
| url | https://doi.org/10.1186/s13014-022-02169-1 |
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