Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide
Background: Glioblastoma (GBM) is a very poor-prognosis brain tumor. To date, maximal excision followed by radiochemotherapy, in 30 fractions, is the standard approach. Limited data are present in the literature about hypofractionated radiotherapy (hypo-RT) in GBM poor prognosis patients. Thus, this...
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MDPI AG
2021-11-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/11/11/1145 |
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| author | Fabiana Gregucci Alessia Surgo Ilaria Bonaparte Letizia Laera Maria Paola Ciliberti Roberta Carbonara Maria Annunziata Gentile David Giraldi Roberto Calbi Morena Caliandro Nicola Sasso Salvatore D’Oria Carlo Somma Gaetano Martinelli Giammarco Surico Giuseppe Lombardi Alba Fiorentino |
| author_facet | Fabiana Gregucci Alessia Surgo Ilaria Bonaparte Letizia Laera Maria Paola Ciliberti Roberta Carbonara Maria Annunziata Gentile David Giraldi Roberto Calbi Morena Caliandro Nicola Sasso Salvatore D’Oria Carlo Somma Gaetano Martinelli Giammarco Surico Giuseppe Lombardi Alba Fiorentino |
| author_sort | Fabiana Gregucci |
| collection | DOAJ |
| description | Background: Glioblastoma (GBM) is a very poor-prognosis brain tumor. To date, maximal excision followed by radiochemotherapy, in 30 fractions, is the standard approach. Limited data are present in the literature about hypofractionated radiotherapy (hypo-RT) in GBM poor prognosis patients. Thus, this retrospective study was conducted to evaluate efficacy and toxicity of hypo-RT with simultaneous integrated boost (SIB) in association with temozolomide (TMZ) in this patient setting. Methods: Poor-prognosis GBM patients underwent surgery (complete, subtotal or biopsy) followed by SIB-hypo-RT and concomitant/adjuvant TMZ. The prescription dose was 40.05 Gy (15 fractions) with a SIB of 52.5 Gy (3.5 Gy/fraction) on surgical cavity/residual/macroscopic disease. Volumetric modulated arc therapy was performed. Results: From July 2019 to July 2021, 30 poor-prognosis patients affected by GBM were treated by SIB-hypo-RT; 25 were evaluated in the present analysis due to a minimum follow up of 6 months. The median age and KPS were 65 years and 60%, respectively. At the median follow-up time of 15 months (range 7–24), median and 1-year overall survival and progression-free survival were 13 months and 54%, and 8.4 months and 23%, respectively. No acute or late neurological side effects of grade ≥ 2 were reported. Grade 3–4 hematologic toxicity occurred in three cases. Conclusion: SIB-hypo-RT associated with TMZ in poor-prognosis patients affected by GBM is an effective and safe treatment. Prospective studies could be warranted. |
| first_indexed | 2024-03-10T05:21:59Z |
| format | Article |
| id | doaj.art-af3579c3dc55499992afbba282d6db59 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T05:21:59Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
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| series | Journal of Personalized Medicine |
| spelling | doaj.art-af3579c3dc55499992afbba282d6db592023-11-22T23:58:35ZengMDPI AGJournal of Personalized Medicine2075-44262021-11-011111114510.3390/jpm11111145Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant TemozolomideFabiana Gregucci0Alessia Surgo1Ilaria Bonaparte2Letizia Laera3Maria Paola Ciliberti4Roberta Carbonara5Maria Annunziata Gentile6David Giraldi7Roberto Calbi8Morena Caliandro9Nicola Sasso10Salvatore D’Oria11Carlo Somma12Gaetano Martinelli13Giammarco Surico14Giuseppe Lombardi15Alba Fiorentino16Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Medical Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Radiology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Neurosurgery, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Radiology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Medical Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Neurosurgery, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Neurosurgery, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Radiology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Medical Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyDepartment of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Padova, ItalyDepartment of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti, Bari, ItalyBackground: Glioblastoma (GBM) is a very poor-prognosis brain tumor. To date, maximal excision followed by radiochemotherapy, in 30 fractions, is the standard approach. Limited data are present in the literature about hypofractionated radiotherapy (hypo-RT) in GBM poor prognosis patients. Thus, this retrospective study was conducted to evaluate efficacy and toxicity of hypo-RT with simultaneous integrated boost (SIB) in association with temozolomide (TMZ) in this patient setting. Methods: Poor-prognosis GBM patients underwent surgery (complete, subtotal or biopsy) followed by SIB-hypo-RT and concomitant/adjuvant TMZ. The prescription dose was 40.05 Gy (15 fractions) with a SIB of 52.5 Gy (3.5 Gy/fraction) on surgical cavity/residual/macroscopic disease. Volumetric modulated arc therapy was performed. Results: From July 2019 to July 2021, 30 poor-prognosis patients affected by GBM were treated by SIB-hypo-RT; 25 were evaluated in the present analysis due to a minimum follow up of 6 months. The median age and KPS were 65 years and 60%, respectively. At the median follow-up time of 15 months (range 7–24), median and 1-year overall survival and progression-free survival were 13 months and 54%, and 8.4 months and 23%, respectively. No acute or late neurological side effects of grade ≥ 2 were reported. Grade 3–4 hematologic toxicity occurred in three cases. Conclusion: SIB-hypo-RT associated with TMZ in poor-prognosis patients affected by GBM is an effective and safe treatment. Prospective studies could be warranted.https://www.mdpi.com/2075-4426/11/11/1145glioblastomapoor prognosisradiotherapychemotherapy |
| spellingShingle | Fabiana Gregucci Alessia Surgo Ilaria Bonaparte Letizia Laera Maria Paola Ciliberti Roberta Carbonara Maria Annunziata Gentile David Giraldi Roberto Calbi Morena Caliandro Nicola Sasso Salvatore D’Oria Carlo Somma Gaetano Martinelli Giammarco Surico Giuseppe Lombardi Alba Fiorentino Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide Journal of Personalized Medicine glioblastoma poor prognosis radiotherapy chemotherapy |
| title | Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide |
| title_full | Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide |
| title_fullStr | Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide |
| title_full_unstemmed | Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide |
| title_short | Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide |
| title_sort | poor prognosis patients affected by glioblastoma retrospective study of hypofractionated radiotherapy with simultaneous integrated boost and concurrent adjuvant temozolomide |
| topic | glioblastoma poor prognosis radiotherapy chemotherapy |
| url | https://www.mdpi.com/2075-4426/11/11/1145 |
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