• Radiology
• Head & Neck Cancers
• Radiation Therapy
• Oncology Clinical Trials

• Radiology
• Head & Neck Cancers
• Oncology
• Radiation Therapy
• Oncology Clinical Trials

Hypofractionated radiotherapy (HRT) is more effective with temozolomide (T) than without it and as effective as standard (Stupp regimen) radiotherapy (SRT) with T in improving the overall survival of elderly patients with glioblastoma (GBM). Shyam Tanguturi, MD, Brigham and Women's Hospital, Boston, Massachusetts, USA, and colleagues presented data from a retrospective study.

The Stupp regimen of HRT (SRT) is commonly used with T for the treatment of elderly patients with GBM. However, there has been insufficient study, and no randomized trials, comparing SRT with and without T to HRT. This retrospective study was designed to compare SRT and HRT alone and with T (SRT + T and HRT + T, respectively).

One hundred thirty-five patients who had been treated with SRT (59.4–60 Gy in 30–33 fractions) or HRT (40 Gy in 15 fractions) alone or with T (SRT + T and HRT + T) and who had been diagnosed with GBM between 1994 and 2013 were included in this study. Prognostic factors and overall survival were calculated.

The primary end point was overall survival. The data were also analyzed to determine if other factors, such as prognostic factors, differed between the groups or were associated with increased mortality.

Overall survival was 9.5, 11.1, 4.1, and 9.6 months for SRT, SRT + T, HRT, and HRT + T, respectively. On multivariable analysis, there was no significant difference in all-cause mortality between HRT + T and SRT + T (P = .57). In contrast, all-cause mortality was significantly higher for HRT alone (P = .007) and for SRT alone (P = .03) compared with SRT + T. Other factors associated with increased mortality were greater age, lower Karnofsky performance score (KPS), and multifocal tumors.

Although the groups were not significantly different in many aspects (such as gender, tumor size, and extent of resection), there were several important exceptions. For example, HRT ± T patients were older than the SRT ± T patients (median age, 79 vs 69 years, respectively) and had lower KPSs.

The authors concluded that adding T to HRT could substantially reduce, and possibly halve, the number of radiotherapy treatments needed for elderly patients with GBM. They recommend randomized trials to further elucidate the effectiveness of HRT + T compared with other treatments.

• © 2014 MD Conference Express®