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Prospective single-arm study of 72 Gy hyperfractionated radiation therapy and combination chemotherapy for anaplastic astrocytomas.

Nomiya T, Nemoto K, Kumabe T, Takai Y, Yamada S - BMC Cancer (2008)

Bottom Line: Three-year PFS rate and LCR were 64.4% (95%CI: 48.4-80.3%) and 81.6% (95%CI: 69.2-94.8%), respectively.The number of failures at 5 years in the HFRT group were 14 (32%).The number of failures inside the irradiation field was only about half (50%) of all failures.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan. t.nomiya@med.id.yamagata-u.ac.jp

ABSTRACT

Background: Despite intensive multimodal treatment, outcome of patients with malignant glioma remains poor, and a standard dose of radiotherapy for anaplastic astrocytoma has not been defined. In the past RTOG study (83-02), the arm of 72 Gy hyperfractionated radiotherapy (HFRT) for malignant gliomas showed better outcome than the arms of higher doses (76.8 - 81.6 Gy) and the arms of lower doses (48 - 54.4 Gy). The purpose of this study is to verify the efficacy of this protocol.

Methods: From July 1995, 44 consecutive eligible patients with histologically proven anaplastic astrocytoma were enrolled in this study (HFRT group). The standard regimen in this protocol was post-operative radiotherapy of 72 Gy in 60 fractions (1.2 Gy/fraction, 2 fractions/day) with concurrent chemotherapy (weekly ACNU). The primary endpoint was local control rate (LCR), and the secondary endpoints were overall survival (OS), progression-free survival (PFS) and late toxicity.

Results: Three-year OS of the HFRT group was 64.8% (95% confidence interval; 48.4-81.3%). Three-year PFS rate and LCR were 64.4% (95%CI: 48.4-80.3%) and 81.6% (95%CI: 69.2-94.8%), respectively. The number of failures at 5 years in the HFRT group were 14 (32%). The number of failures inside the irradiation field was only about half (50%) of all failures. One (2%) of the patients clinically diagnosed as brain necrosis due to radiation therapy.

Conclusion: The results of this study suggested that 72 Gy HFRT seemed to show favorable outcome for patients with anaplastic astrocytoma with tolerable toxicity.

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Overall survival rates of the HFRT group. Three-year and 5-year overall survival rates were 64.8% and 60.8%, respectively.
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Figure 1: Overall survival rates of the HFRT group. Three-year and 5-year overall survival rates were 64.8% and 60.8%, respectively.

Mentions: Figure 1 shows the overall survival curve of the 44 patients. Three-year overall survival rate of the HFRT group was 64.8% (95% confidence interval: 48.4–81.3%) and 5-year overall survival rate was 60.9% (95%CI: 43.6 – 71.2%). Three-year and 5-year PFS rates were 64.4% (95%CI: 48.4% – 80.3%) and 53.7% (95% CI: 30.4 – 77.1%), respectively (Figure 2). Three-year and 5-year LCRs were 81.6% (69.2 – 94.8%: 95%CI) and 81.6% (95%CI: 69.2–94.8%), respectively (Figure 3).


Prospective single-arm study of 72 Gy hyperfractionated radiation therapy and combination chemotherapy for anaplastic astrocytomas.

Nomiya T, Nemoto K, Kumabe T, Takai Y, Yamada S - BMC Cancer (2008)

Overall survival rates of the HFRT group. Three-year and 5-year overall survival rates were 64.8% and 60.8%, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2254433&req=5

Figure 1: Overall survival rates of the HFRT group. Three-year and 5-year overall survival rates were 64.8% and 60.8%, respectively.
Mentions: Figure 1 shows the overall survival curve of the 44 patients. Three-year overall survival rate of the HFRT group was 64.8% (95% confidence interval: 48.4–81.3%) and 5-year overall survival rate was 60.9% (95%CI: 43.6 – 71.2%). Three-year and 5-year PFS rates were 64.4% (95%CI: 48.4% – 80.3%) and 53.7% (95% CI: 30.4 – 77.1%), respectively (Figure 2). Three-year and 5-year LCRs were 81.6% (69.2 – 94.8%: 95%CI) and 81.6% (95%CI: 69.2–94.8%), respectively (Figure 3).

Bottom Line: Three-year PFS rate and LCR were 64.4% (95%CI: 48.4-80.3%) and 81.6% (95%CI: 69.2-94.8%), respectively.The number of failures at 5 years in the HFRT group were 14 (32%).The number of failures inside the irradiation field was only about half (50%) of all failures.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan. t.nomiya@med.id.yamagata-u.ac.jp

ABSTRACT

Background: Despite intensive multimodal treatment, outcome of patients with malignant glioma remains poor, and a standard dose of radiotherapy for anaplastic astrocytoma has not been defined. In the past RTOG study (83-02), the arm of 72 Gy hyperfractionated radiotherapy (HFRT) for malignant gliomas showed better outcome than the arms of higher doses (76.8 - 81.6 Gy) and the arms of lower doses (48 - 54.4 Gy). The purpose of this study is to verify the efficacy of this protocol.

Methods: From July 1995, 44 consecutive eligible patients with histologically proven anaplastic astrocytoma were enrolled in this study (HFRT group). The standard regimen in this protocol was post-operative radiotherapy of 72 Gy in 60 fractions (1.2 Gy/fraction, 2 fractions/day) with concurrent chemotherapy (weekly ACNU). The primary endpoint was local control rate (LCR), and the secondary endpoints were overall survival (OS), progression-free survival (PFS) and late toxicity.

Results: Three-year OS of the HFRT group was 64.8% (95% confidence interval; 48.4-81.3%). Three-year PFS rate and LCR were 64.4% (95%CI: 48.4-80.3%) and 81.6% (95%CI: 69.2-94.8%), respectively. The number of failures at 5 years in the HFRT group were 14 (32%). The number of failures inside the irradiation field was only about half (50%) of all failures. One (2%) of the patients clinically diagnosed as brain necrosis due to radiation therapy.

Conclusion: The results of this study suggested that 72 Gy HFRT seemed to show favorable outcome for patients with anaplastic astrocytoma with tolerable toxicity.

Show MeSH
Related in: MedlinePlus