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Feasibility evaluation of hypofractionated radiotherapy with concurrent temozolomide in elderly patients with glioblastoma

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Abstract

Background

Although 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.

Methods

We 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/m2 for 5 days and 4 received TMZ at 75 mg/m2 during HFRT. Overall survival (OS) was defined as the time from surgery to death or the last follow-up.

Results

The 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.

Conclusion

Our 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.

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Acknowledgments

This work was supported by JSPS KAKENHI Grant Number 15K18444 and JSPS KAKENHI Grant Number 25462254.

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Authors and Affiliations

  1. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Megumi Uto, Takashi Mizowaki, Kengo Ogura & Masahiro Hiraoka

  2. Department of Neurosurgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Yoshiki Arakawa, Yohei Mineharu & Susumu Miyamoto

Authors
  1. Megumi Uto
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  2. Takashi Mizowaki
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  3. Kengo Ogura
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  4. Yoshiki Arakawa
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  5. Yohei Mineharu
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  6. Susumu Miyamoto
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  7. Masahiro Hiraoka
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Corresponding author

Correspondence to Takashi Mizowaki.

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Uto, M., Mizowaki, T., Ogura, K. et al. Feasibility evaluation of hypofractionated radiotherapy with concurrent temozolomide in elderly patients with glioblastoma. Int J Clin Oncol 21, 1023–1029 (2016). https://doi.org/10.1007/s10147-016-1014-9

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  • DOI: https://doi.org/10.1007/s10147-016-1014-9

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