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Journal of Neurosurgical Sciences 2015 December;59(4):447-53

lingua: Inglese

Hypofractionated irradiation for gliomas with 45.5Gy in 13 fractions: a retrospective study

Kouloulias V. 1, Zygogianni A. 2, Kouvaris J. 2, Platoni K. 1, Georgakopoulos J. 1, Boviatsis E. 3, Beli I. 1, Tolia M. 1, Antypas C. 2, Karaiskos P. 3, Scarleas C. 3, Asimakopoulos C. 1, Pantelakos P. 1, Kelekis N. 1

1 2nd Department of Radiology, Radiotherapy Unit, ATTIKON University Hospital Medical School, Athens, Greece;
2 1st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital Medical School, Athens, Greece;
3 2nd Neurosurgery Department, ATTIKON University Hospital Medical School, Athens, Greece;
4 Radiotherapy Department, Hygeia Hospital, Athens, Greece


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AIM: The aim of the present retrospective study was to evaluate the efficacy and toxicity of a hypofractionated radiotherapy (HFRT) schedule for grade IV glioblastoma multiforme (GBM).
METHODS: Fourteen elderly patients with KPS less than 70, received 13 fractions of 350cGy with 3D-conformal technique (3DCRT) and non-coplanar fields. Acute and late skin and CNS toxicity was graded according to EORTC/RTOG criteria.
RESULTS: The median follow-up was 9 months. All patients completed the irradiation without interruptions due to toxicity and received temozolomide (TMZ) after the completion of 3DCRT. The KPS during RT and at follow-up was not significantly changed (P=0.108). The median overall survival was 7 months. No severe skin acute or late toxicity was noted. In terms of CNS toxicity, only one patient presented grade III toxicity requiring hospitalization for two days. The irradiation schedule of 45.5Gy in 13 fractions seems effective and without moderate or severe toxicity.
CONCLUSION: The suggested HFRT schedule might be an alternative one, for elderly patients with dismal prognosis, unfit for six weeks of daily irradiation. Prospective studies are needed for further validation of our results, especially with the use of TMZ.

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vkouloul@ece.ntua.gr