Chemopotentiation by Ultrafractionated Radiotherapy in Glioblastoma Resistant to Conventional Therapy
Chemopotentiation by Ultrafractionated Radiotherapy in Glioblastoma Resistant to Conventional Therapy
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DOI：
10.1177/030089161009600522
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发表时间：
2010-09
期刊：
影响因子：
1.9
通讯作者：
C. Jahraus;A. Friedman
中科院分区：
文献类型：
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作者：
C. Jahraus;A. Friedman
诱导性辐射抵抗(IRR)和超放射敏感性(HRS)是基础文献中常见的现象，但将其应用于临床以造福患者的报道很少。胶质母细胞瘤就是一个很好的例子。病例和方法描述一位82岁女性的病例，其切除的额顶胶质母细胞瘤通过按标准方法进行治疗而进展。在审查委员会和患者的批准下，我们继续使用放射治疗和替莫唑胺治疗，但大幅修改了放射治疗的分割，在14天周期的前5天每天两次给予50cGy.替莫唑胺在每个周期的前4天给药。我们使用术语“超分割放射治疗”来指代在这种情况下使用的极低剂量的放射治疗。结果此改良方案使MRI上发现的疾病复发的对比剂增强区域消退，患者在之前的全剂量治疗后接受了5个周期的额外治疗，在HER病复发后存活了大约6个月。结论超分割放射治疗与替莫唑胺同步治疗对本病有效，且耐受性好，肿瘤进展通过常规治疗。有必要对这种方法进行更多的研究。免费全文可在www.tomorionline.it上查阅
Introduction Induced radiation resistance (IRR) and hyper-radiosensitivity (HRS) are well-described phenomena in basic literature, yet few reports have been published in which such phenomena are exploited clinically for the benefit of patients. Glioblastoma is a prime example. Case and methods The case of an 82-year-old woman is described whose resected frontoparietal glioblastoma progressed through treatment administered according to standard methods. With review board and patient approval, we continued her treatment using radiotherapy and temozolomide, but drastically modified the radiotherapy fractionation, administering 50 cGy twice daily on each of the first 5 days of a 14-day cycle. Temozolomide was administered on the first 4 days of each cycle. We use the term “ultrafractionated radiotherapy” to refer to the extremely low doses of radiation used in this case. Results This modified regimen resulted in regression of the contrast-enhancing areas of disease recurrence identified on MRI, and the patient survived approximately 6 months following recurrence of her disease, having received 5 cycles of additional therapy after prior full-dose treatment. Conclusions Ultrafractionated radiotherapy and concurrent temozolomide were efficacious and tolerable in this patient whose glioblastoma previously progressed through conventional treatment. Additional studies of this approach are warranted. Free full text available at www.tumorionline.it