Hypofractionated stereotactic radiotherapy and continuous low-dose temozolomide in patients with recurrent or progressive malignant gliomas

Autor: Teresa Falco, Vitaliana De Sanctis, Riccardo Maurizi Enrici, Giuseppe Minniti, Claudia Scaringi, Vincenzo Esposito, Gaetano Lanzetta, Domenica Di Stefano
Rok vydání: 2012
Předmět:
Male
Oncology
Cancer Research
medicine.medical_treatment
drug therapy/surgery
analogs /&/ derivatives/therapeutic use
antineoplastic agents
Brain Neoplasms
Glioblastoma
High grade glioma
Recurrence
Reirradiation
Stereotactic radiotherapy
Temozolomide
Glioma
Middle Aged
Dihydroxyphenylalanine
Dacarbazine
alkylating
Neurology
analogs /&/ derivatives/diagnostic use
stereotactic radiotherapy
Female
methods
high grade glioma
brain neoplasms
aged
karnofsky performance status
glioma
temozolomide
follow-up studies
dihydroxyphenylalanine
retrospective studies
disease-free survival
therapeutic use
reirradiation
dacarbazine
male
middle aged
adult
humans
radiosurgery
recurrence
female
glioblastoma
Adjuvant
medicine.drug
Adult
medicine.medical_specialty
Radiosurgery
Disease-Free Survival
Internal medicine
medicine
Humans
Karnofsky Performance Status
Antineoplastic Agents
Alkylating
Aged
Retrospective Studies
business.industry
Retrospective cohort study
medicine.disease
Surgery
Regimen
Concomitant
Neurology (clinical)
business
Follow-Up Studies
Zdroj: Journal of Neuro-Oncology. 111:187-194
ISSN: 1573-7373
0167-594X
Popis: To evaluate the efficacy of reirradiation and systemic chemotherapy as salvage treatment in patients with recurrent malignant glioma. Between May 2006 and December 2011, 54 patients with recurrent malignant glioma received hypofractionated stereotactic radiotherapy (HSRT) plus systemic therapy at University of Rome Sapienza, Sant' Andrea Hospital. All patients had Karnofsky performance score ≥60 and were previously treated with standard conformal RT (60 Gy) with concomitant and adjuvant temozolomide (TMZ) up to 12 cycles. Thirty-eight patients had a GBM and 16 patients had a grade 3 glioma. The median time interval between primary RT and reirradiation was 15.5 months. At the time of recurrence all patients received HSRT (30 Gy in 6-Gy fractions) plus concomitant TMZ (75 mg/m(2)/day) followed by continuous TMZ at 50 mg/m(2) everyday up to 1 year or until progression. Median overall survival after HSRT was 12.4 months, and the 12- and 24-month survival rates were 53 and 16 %, respectively. The median progression-free survival (PFS) was 6 months, and the 12- and 24-month PFS rates were 24 and 10 %, respectively. KPS >70 (P = 0.04) and grade 3 glioma were independent favourable prognostic factors for survival. In general chemoradiation regimen was well tolerated with relatively low treatment-related toxicity. HSRT plus concomitant TMZ followed by continuous dose-intense TMZ is a feasible treatment option associated with survival benefits and low risk of complications in selected patients with recurrent malignant glioma. The potential advantages of combined chemoradiation schedules in patients with recurrent malignant gliomas need to be explored in future studies.
Databáze: OpenAIRE
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