HYPOFRACTIONATED RADIOTHERAPY IN GLIOBLASTOMA MULTIFORME

Abstract

Purpose: The purpose of this study was to assess the outcomes in glioblastoma patients treated with hypofractionated radiotherapy.Materials and Methods: We reviewed all glioblastoma patients treated at our specialist cancer centre over 7 and a 1⁄2 years using hypofractionated radiotherapy (HRT) postoperatively. The HRT regimen was 48 Gy given at 3 Gy/ fractions in 16 fractions. We calculated overall survival using time to event analyses. Results: A total of 62 patients were identi ed of whom 44 (71%) were male. The median age of these patients was 50 years (range: 20–71 years). Eastern Cooperative Oncology Group (ECOG) performance status was 0 in 47 (76%) and 1 in 15 (24%) patients. 7 (11%) of the patients underwent gross total resection, 52 (83%) had subtotal resection and 3 (5%) had a biopsy only. Response assessment on magnetic resonance imaging at 3-month post-HRT showed that 14 (22%) patients had regression, 21 (34%) were stable and 22 (35%) had a progressive primary tumour. 5 (8%) patients were lost to follow up. With a median follow-up of 7.8 months, the median overall survival was 9 months. Patients with ECOG-0 showed a median survival of 7 months as compared to 6 months for those with ECOG-1. Patients with stable or partial response showed a median overall survival of 8 months in comparison to 6 months for those with progressive disease. There were no signi cant differences in median survival based on the extent of surgery. A Cox multivariate model con rmed signi cant correlation of age and response to radiotherapy with survival. Conclusion: HRT consisting of 48 Gy in 3 weeks can be used for selected glioblastoma patients to reduce the overall treatment time of conventional radiotherapy by 35–40% without apparent increased toxicity or decrement in survival in a low resource environment. Key words: Chemoradiation, glioblastoma, hypofractionated radiotherapy, survival