title: Hypofractionated radiotherapy as palliative treatment in poor prognosis patients with high grade glioma.
abstract: We report the palliative effectiveness of a hypofractionated radiotherapy regimen in patients with poor prognosis high grade glioma. Thirty-eight elderly, and/or disabled patients received radiotherapy to a dose of 30 Gy in 6 fractions over 2 weeks to a planning target volume defined by the enhancing tumour and a 2-cm margin. The median survival was 6 months with a 1-year survival rate of 23%. Treatment was without acute toxicity. One month after radiotherapy, functional status, assessed using a verbally administered Barthel index, improved in 38% and remained stable in a further 39% of surviving patients. At 3 months 39% of surviving patients had improved and a further 12% remained stable. We conclude that in the poor prognostic group of patients with high grade glioma hypofractionated partial brain radiotherapy is well tolerated, convenient and provides effective palliation in a proportion of patients. Comparison with conventional radiotherapy or symptomatic care alone require further evaluation in randomised studies.
authors.affiliation: Neuro-oncology Unit, Royal Marsden Hospital, Sutton, Surrey, UK.
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: N
authors.initials: N
authors.lastname: James
authors.forename: D
authors.initials: D
authors.lastname: Guerrero
authors.forename: S
authors.initials: S
authors.lastname: Ashley
authors.forename: A
authors.initials: A
authors.lastname: Gregor
authors.forename: M
authors.initials: M
authors.lastname: Brada
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005910:Glioma / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011879:Radiotherapy Dosage; D016019:Survival Analysis