Efficacy of high dose radiotherapy in post-operative treatment of glioblastoma multiform--a single institution report
| Autor: | Afsane Maddah Safaei, Abdolazim Sedighi Pashaki, Kamal Mohamadian, Mohammad Abassi, Tayebe Torkaman, Ehsan Akbari Hamed |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Epidemiology medicine.medical_treatment Young Adult Median follow-up medicine Humans Progression-free survival Postoperative Period Survival rate Aged Neoplasm Staging Chemotherapy business.industry Brain Neoplasms Public Health Environmental and Occupational Health Radiotherapy Dosage Middle Aged Prognosis Surgery Clinical trial Radiation therapy Survival Rate Oncology Tumor progression Female Neoplasm Recurrence Local business Glioblastoma Adjuvant Follow-Up Studies |
| Zdroj: | Asian Pacific journal of cancer prevention : APJCP. 15(6) |
| ISSN: | 2476-762X |
| Popis: | Background: Glioblastoma multiform (GBM) is a highly aggressive tumor with median survival of approximately 14 months. Management consists of maximal surgical resection followed by post-operative chemoradiation with concurrent then adjuvant temozolamide. The standard radiotherapy dose is 60Gy in 2-Gy fractions recommended by the radiation therapy oncology group (RTOG). With the vast majority of tumor recurrences occurring within the previous irradiation field and the poor outcome associated with standard therapy, regimens designed to deliver higher radiation doses to improve local control and enhance survival are needed. In this study, we report a single institutional experience in treatment of 68 consecutive patients with GBM, treated with resection, and given post-operative radiotherapy followed by concurrent and/or adjuvant chemotherapy. Results: Of the 80 patients who entered this study, 68 completed the treatment course; 45 (66.2%) males and 23 (33.8%) females with a mean age at diagnosis of 49.0±12.9 (21-75) years. At a median follow up of 19 months, 39 (57.3%) patients had evidence of tumor progression and 36 (52.9%) had died. The median over all survival for all patients was 16 months and progression free survival for all patients was 6.02 months. All potential prognostic factors were analyzed to evaluate their effects on overall survival. Age ≤50 year, concurrent and adjuvant chemotherapy and extent of surgery had significant p values. We found lower progression rate among patients who received higher doses of radiotherapy (>60Gy). Higher radiation doses improved progression free survival (p=0.03). Despite increasing overall survival, this elevation was not significant. Conclusions: This study emphasize that higher radiation doses of (>60Gy) can improve local control and potentially survival, so we strongly advise prospective multi centric studies to evaluate the role of higher doses of radiotherapy on GBM patient outcome. |
| Databáze: | OpenAIRE |
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