Feasibility evaluation of hypofractionated radiotherapy with concurrent temozolomide in elderly patients with glioblastoma.
Feasibility evaluation of hypofractionated radiotherapy with concurrent temozolomide in elderly patients with glioblastoma.
复制标题
大分割放疗联合替莫唑胺治疗老年胶质母细胞瘤的可行性评估。
DOI：
10.1007/s10147-016-1014-9
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Masahiro Hiraoka.
中科院分区：
文献类型：
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作者：
8.Megumi Uto;Takashi Mizowaki;Kengo Ogura;Yoshiki Arakawa;Yohei Mineharu;Susumu Miyamoto;Masahiro Hiraoka.
背景尽管在治疗老年胶质母细胞瘤患者时，大分割放射治疗（HFRT）优于常规分割放射治疗，但HFRT联合替莫唑胺（TMZ）治疗老年胶质母细胞瘤患者的获益和耐受性尚不清楚。我们评估了HFRT和并发TMZ.MethodsWe治疗胶质母细胞瘤的老年患者的可行性和结果回顾性分析了11例年龄≥70岁的HFRT和并发TMZ治疗的患者的病历。所有患者均为新诊断并经组织学证实的胶质母细胞瘤，并于2011年10月至2015年4月期间在我们的机构接受治疗。中位年龄为74岁（范围：70-85岁）。2/5/4例患者分别行全切除/次全切除/活检。计划靶体积包括T1增强肿瘤和切除腔加上2 cm边缘，以及所有周围水肿。中位处方剂量为35戈伊（范围：35-42.5戈伊），分10次给药。7例患者在HFRT期间接受TMZ 150 mg/m2治疗5 d，4例患者接受TMZ 75 mg/m2治疗。总生存期（OS）定义为从手术到死亡或末次随访的时间。中位OS和无进展生存期（PFS）时间分别为13.2和7.0个月。1例患者发生4级中性粒细胞减少症、淋巴细胞减少症和血小板减少症。没有3级或更高的nonhematological不良事件noted.ConclusionOur分析表明HFRT与并发TMZ用于治疗老年胶质母细胞瘤患者的可行性。需要进一步的前瞻性临床试验来确定平衡疗效和耐受性的治疗方法。
BackgroundAlthough hypofractionated radiotherapy (HFRT) is preferred to conventionally fractionated radiotherapy when treating elderly patients with glioblastoma, the benefits and tolerability of HFRT with concurrent temozolomide (TMZ) remain unknown for such patients. We assessed the feasibility and outcomes of elderly patients with glioblastoma treated with HFRT and concurrent TMZ.MethodsWe retrospectively reviewed the medical records of 11 patients aged ≥70 years who were treated with HFRT and concurrent TMZ. All patients had newly diagnosed and histologically confirmed glioblastoma and were treated at our institution between October 2011 and April 2015. The median age was 74 years (range, 70–85 years). Total resection/subtotal resection/biopsy were performed in 2/5/4 patients, respectively. The planning target volume included the T1-enhancing tumor and the resection cavity plus 2-cm margins, and all surrounding edema. The median prescription dose was 35 Gy (range, 35–42.5 Gy), delivered in 10 fractions. Seven patients received TMZ at 150 mg/m2for 5 days and 4 received TMZ at 75 mg/m2during HFRT. Overall survival (OS) was defined as the time from surgery to death or the last follow-up.ResultsThe median follow-up period was 13.2 months. The median OS and progression-free survival (PFS) times were 13.2 and 7.0 months, respectively. One patient experienced grade 4 neutropenia, lymphocytopenia, and thrombocytopenia. No grade 3 or higher nonhematological adverse event was noted.ConclusionOur analysis demonstrated the feasibility of HFRT with concurrent TMZ used to treat elderly patients with glioblastoma. Further prospective clinical trials are needed to define therapies that balance efficacy with tolerability.