Erschienen in:
01.04.2014 | Original article
Low-dose fractionated radiotherapy and concomitant chemotherapy for recurrent or progressive glioblastoma
Final report of a pilot study
verfasst von:
M. Balducci, B. Diletto, S. Chiesa, G.R. D’Agostino, M.A. Gambacorta, M. Ferro, C. Colosimo, G. Maira, C. Anile, V. Valentini
Erschienen in:
Strahlentherapie und Onkologie
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Ausgabe 4/2014
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Abstract
Backgroud
Evaluated in this study were the feasibility and the efficacy of concurrent low dose fractionated radiotherapy (LD-FRT) and chemotherapy as palliative treatment for recurrent/progressive glioblastoma multiforme (GBM).
Patients and methods
Eligible patients had recurrent or progressive GBM, Karnofsky performance status ≥ 70, prior surgery, and standard radiochemotherapy treatment. Recurrence/progression disease during temozolomide (TMZ) received cisplatin (CDDP; 30 mg/m2 on days 1, 8, 15), fotemustine (FTM; 40 mg/m2 on days 2, 9, 16), and concurrent LD-FRT (0.3 Gy twice daily); recurrence/progression after 4 months from the end of adjuvant TMZ were treated by TMZ (150/200 mg/m2 on days 1–5) concomitant with LD-FRT (0.4 Gy twice daily). Primary endpoints were safety and toxicity.
Results
A total of 32 patients were enrolled. Hematologic toxicity G1–2 was observed in 18.7 % of patients and G3–4 in 9.4 %. One patient (3.1 %) had complete response, 3 (9.4 %) had partial response, 8 (25 %) had stable disease for at least 8 weeks, while 20 patients (62.5 %) experienced progressive disease. The clinical benefit was 37.5 %. Median progression-free survival (PFS) and overall survival (OS) were 5 and 8 months, respectively. Survival rate at 12 months was of 27.8 %.
Conclusion
LD-FRT and chemotherapy for recurrent/progressive GBM have a good toxicity profile and clinical outcomes, even though further investigation of this novel palliative treatment approach is warranted.