title: Hypofractionated irradiation for gliomas with 45.5Gy in 13 fractions: a retrospective study.
abstract: OBJECTIVE
  The aim of the present retrospective study was to evaluate the efficacy and toxicity of a hypofractionated radiotherapy (HFRT) schedule for grade IV glioblastoma multiforme (GBM).
  
  
  METHODS
  Fourteen elderly patients with KPS less than 70, received 13 fractions of 350cGy with 3D-conformal technique (3DCRT) and non-coplanar fields. Acute and late skin and CNS toxicity was graded according to EORTC/RTOG criteria.
  
  
  RESULTS
  The median follow-up was 9 months. All patients completed the irradiation without interruptions due to toxicity and received temozolomide (TMZ) after the completion of 3DCRT. The KPS during RT and at follow-up was not significantly changed (P=0.108). The median overall survival was 7 months. No severe skin acute or late toxicity was noted. In terms of CNS toxicity, only one patient presented grade III toxicity requiring hospitalization for two days. The irradiation schedule of 45.5Gy in 13 fractions seems effective and without moderate or severe toxicity.
  
  
  CONCLUSIONS
  The suggested HFRT schedule might be an alternative one, for elderly patients with dismal prognosis, unfit for six weeks of daily irradiation. Prospective studies are needed for further validation of our results, especially with the use of TMZ.
authors.affiliation: 2nd Department of Radiology Radiotherapy Unit, ATTIKON University Hospital Medical School, Athens, Greece - vkouloul@ece.ntua.gr.
authors.forename: V
authors.initials: V
authors.lastname: Kouloulias
authors.forename: A
authors.initials: A
authors.lastname: Zygogianni
authors.forename: J
authors.initials: J
authors.lastname: Kouvaris
authors.forename: K
authors.initials: K
authors.lastname: Platoni
authors.forename: J
authors.initials: J
authors.lastname: Georgakopoulos
authors.forename: E
authors.initials: E
authors.lastname: Boviatsis
authors.forename: I
authors.initials: I
authors.lastname: Beli
authors.forename: M
authors.initials: M
authors.lastname: Tolia
authors.forename: C
authors.initials: C
authors.lastname: Antypas
authors.forename: P
authors.initials: P
authors.lastname: Karaiskos
authors.forename: C
authors.initials: C
authors.lastname: Scarleas
authors.forename: C
authors.initials: C
authors.lastname: Asimakopoulos
authors.forename: P
authors.initials: P
authors.lastname: Pantelakos
authors.forename: N
authors.initials: N
authors.lastname: Kelekis
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D005910:Glioma / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D000069473:Radiation Dose Hypofractionation; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies