title: International Atomic Energy Agency Randomized Phase III Study of Radiation Therapy in Elderly and/or Frail Patients With Newly Diagnosed Glioblastoma Multiforme.
abstract: OBJECTIVE
  The optimal radiotherapy regimen for elderly and/or frail patients with newly diagnosed glioblastoma remains to be established. This study compared two radiotherapy regimens on the outcome of these patients.
  
  
  METHODS
  Between 2010 and 2013, 98 patients (frail = age ≥ 50 years and Karnofsky performance status [KPS] of 50% to 70%; elderly and frail = age ≥ 65 years and KPS of 50% to 70%; elderly = age ≥ 65 years and KPS of 80% to 100%) were prospectively randomly assigned to two arms in a 1:1 ratio, stratified by age (< and ≥ 65 years old), KPS, and extent of surgical resection. Arm 1 received short-course radiotherapy (25 Gy in five daily fractions over 1 week), and arm 2 received commonly used radiotherapy (40 Gy in 15 daily fractions over 3 weeks).
  
  
  RESULTS
  The short-course radiotherapy was noninferior to commonly used radiotherapy. The median overall survival time was 7.9 months (95% CI, 6.3 to 9.6 months) in arm 1 and 6.4 months (95% CI, 5.1 to 7.6 months) in arm 2 (P = .988). Median progression-free survival time was 4.2 months (95% CI, 2.5 to 5.9) in arm 1 and 4.2 months (95% CI, 2.6 to 5.7) in arm B (P = .716). With a median follow-up time of 6.3 months, the quality of life between both arms at 4 weeks after treatment and 8 weeks after treatment was not different.
  
  
  CONCLUSIONS
  There were no differences in overall survival time, progression-free survival time, and quality of life between patients receiving the two radiotherapy regimens. In view of the reduced treatment time, the short 1-week radiotherapy regimen may be recommended as a treatment option for elderly and/or frail patients with newly diagnosed glioblastoma.
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria. wilson.roa@albertahealthservices.ca.
authors.forename: Wilson
authors.initials: W
authors.lastname: Roa
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Lucyna
authors.initials: L
authors.lastname: Kepka
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Narendra
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Valery
authors.initials: V
authors.lastname: Sinaika
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Juliana
authors.initials: J
authors.lastname: Matiello
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Darejan
authors.initials: D
authors.lastname: Lomidze
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Dalenda
authors.initials: D
authors.lastname: Hentati
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Douglas
authors.initials: D
authors.lastname: Guedes de Castro
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Dyttus-Cebulok
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Drodge
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Sunita
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Branislav
authors.initials: B
authors.lastname: Jeremić
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rosenblatt
authors.affiliation: Wilson Roa, Suzanne Drodge, and Sunita Ghosh, University of Alberta, Alberta Health Services-Cancer Control, Edmonton, Alberta, Canada; Lucyna Kepka, Warmia and Mazury Oncology Center, Olsztyn; Katarzyna Dyttus-Cebulok, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Narendra Kumar, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Valery Sinaika, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; Juliana Matiello, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre; Douglas Guedes de Castro, Castro DG, AC Camargo Cancer Center, São Paulo, Brazil; Darejan Lomidze, High Technology Medical Center, University Clinic, Tbilisi, Georgia; Dalenda Hentati, Institut National de Cancer Salah Azaiz, Ministère de la Santé Publique, Bab Saadoum, Tunisia; Branislav Jeremić, Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, Serbia; and Eduardo Rosenblatt and Elena Fidarova, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Elena
authors.initials: E
authors.lastname: Fidarova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D016330:Frail Elderly; D005909:Glioblastoma / Q000175:diagnosis / Q000532:radiotherapy*; D006801:Humans; D007390:International Agencies; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009678:Nuclear Energy; D011788:Quality of Life; D016896:Treatment Outcome