Prospective single-arm study of 72 Gy hyperfractionated radiation therapy and combination chemotherapy for anaplastic astrocytomas.

Abstract

BACKGROUND:

Despite intensive multimodal treatment, outcome of patients with malignant glioma remains poor, and a standard dose of radiotherapy for anaplastic astrocytoma has not been defined. In the past RTOG study (83-02), the arm of 72 Gy hyperfractionated radiotherapy (HFRT) for malignant gliomas showed better outcome than the arms of higher doses (76.8 - 81.6 Gy) and the arms of lower doses (48 - 54.4 Gy). The purpose of this study is to verify the efficacy of this protocol.

METHODS:

From July 1995, 44 consecutive eligible patients with histologically proven anaplastic astrocytoma were enrolled in this study (HFRT group). The standard regimen in this protocol was post-operative radiotherapy of 72 Gy in 60 fractions (1.2 Gy/fraction, 2 fractions/day) with concurrent chemotherapy (weekly ACNU). The primary endpoint was local control rate (LCR), and the secondary endpoints were overall survival (OS), progression-free survival (PFS) and late toxicity.

RESULTS:

Three-year OS of the HFRT group was 64.8% (95% confidence interval; 48.4-81.3%). Three-year PFS rate and LCR were 64.4% (95%CI: 48.4-80.3%) and 81.6% (95%CI: 69.2-94.8%), respectively. The number of failures at 5 years in the HFRT group were 14 (32%). The number of failures inside the irradiation field was only about half (50%) of all failures. One (2%) of the patients clinically diagnosed as brain necrosis due to radiation therapy.

CONCLUSION:

The results of this study suggested that 72 Gy HFRT seemed to show favorable outcome for patients with anaplastic astrocytoma with tolerable toxicity.

• Authors: Takuma Nomiya, Kenji Nemoto, Toshihiro Kumabe, Yoshihiro Takai, Shogo Yamada
• Journal: BMC cancer (BMC Cancer) Vol. 8 Pg. 11 (Jan 16 2008) ISSN: 1471-2407 [Electronic] England
• PMID: 18199339 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antineoplastic Agents
• Nimustine

Topics

• Adult
• Antineoplastic Agents (adverse effects, therapeutic use)
• Astrocytoma (drug therapy, radiotherapy, surgery)
• Brain Neoplasms (drug therapy, radiotherapy, surgery)
• Combined Modality Therapy
• Dose Fractionation, Radiation
• Female
• Humans
• Male
• Nimustine (adverse effects, therapeutic use)