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• W2095359706 abstract "HFSRT with concurrent CTX is well tolerated in patients with recurrent and newly diagnosed resected small GBM (max dimension ≤5 cm and volume <60 cc) in young patients with good KPS. This study reports the initial experience on the feasibility and efficacy of HFSRT with concurrent CTX for patients with GBM who carry an especially poor prognosis in light of unresectable disease or a poor function status. Twelve patients (7 men and 5 women) with GBM and RTOG RPA class V-VI underwent maximally safe resection or biopsy (when considered inoperable), followed by HFSRT between 2011 and 2013. HFSRT was given with dose painting in 6 treatments over 2 weeks. Prescribed dose was 6 x 6 Gy to contrast-enhancing tumor + 5 mm margin (CTV1) and 6 x 4 Gy to FLAIR hypersignal + 2 cm (CTV2). Additional 5 mm expansion was used to create both PTVs. HFSRT was delivered concomitant with temozolomide (TMZ) (75 mg/m2 daily), followed by adjuvant TMZ (150-200 mg/m2 in 5/28 days). Two patients also received additional concurrent bevacizumab (10 mg/kg every 2 weeks). Response was assessed based on the Response Assessment in Neuro-Oncology criteria. Electronic medical records were reviewed for acute toxicity, dexamethasone dosage, disease response, progression free survival (PFS) and median survival (MS). Median age at diagnosis was 65 years (range, 50-82 years) and median pre-radiation KPS = 60 (range, 40-70). The median pre-operative maximum dimension of the gross tumor on MRI was 5.4 cm (range, 1.9-8.5 cm). Three patients had gross total resection, 4 had subtotal resection, and 5 had biopsy only. The treatment was well tolerated without RTOG grade 3/4 acute toxicities. All patients were on dexamethasone at start of radiation and no increase in dosage was required in any of the patients during treatment. Three (30%) patients had dose taper during and another 3 had taper shortly after completion of radiation. Of the 8 patients with available follow-up data, 1 (13%) had partial response, 6 (75%) stable disease, and 1 (13%) progression of disease after HFSRT. With median follow-up of 8 months (range, 4-15 months), 2/8 (25%) of the patients had died. MS has not yet been reached. Median PFS was reached at 8 months from completion of HFSRT. The HFSRT regimen with concurrent TMZ was safe, well tolerated and convenient for patients with the poorest GBM prognosis, rendering a shorter overall treatment time with no increase in steroid requirement during treatment. Compared to the historical median survival of 5-9 months in patients with RPA class V-VI, HFSRT appeared to have done well, likely owing to the more aggressive radiation fractionation and concurrent TMZ. Further clinical trial exploring this HFRT in GBM patients with poorest prognosis is warranted." @default.
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• W2095359706 date "2013-10-01" @default.
• W2095359706 modified "2023-09-26" @default.
• W2095359706 title "Hypofractionated Stereotactic Radiation Therapy (HFSRT) With Concurrent Chemotherapy (CTX) in Patients With Newly Diagnosed Poor Prognosis GBM: Early Results" @default.
• W2095359706 doi "https://doi.org/10.1016/j.ijrobp.2013.06.649" @default.
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