适形放疗（CF-RT）与低分割放疗（HF-RT）治疗脑胶质母细胞瘤的比较

Hypo-fractionated Radiotherapy (HF-RT) Conventionally Fractionated Radiotherapy (CF-RT) for Glioblastoma.

机构信息

Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.

Department of Neurosurgery, Romodanov Neurosurgery Institute, Kyiv, Ukraine.

出版信息

Anticancer Res. 2023 Jul;43(7):3121-3128. doi: 10.21873/anticanres.16484.

DOI:10.21873/anticanres.16484

PMID:37351960

Abstract

BACKGROUND/AIM: Hypo-fractionated radiotherapy (HF-RT) is increasingly used for elderly and frail glioblastoma patients. In countries with limited radiotherapy capacities, HF-RT is more widely applied. This allowed us to compare conventional fractionation (CF-RT) vs. HF-RT in patients of any age and performance status.

PATIENTS AND METHODS

We retrospectively analysed 277 patients [110 HF-RT (52.5 Gy in 15 fractions) vs. 167 CF-RT (54.0-60.0 Gy in 27-33 fractions)] for local control (LC) and overall survival (OS) including subgroups considering specific patient characteristics.

RESULTS

On univariable comparisons, CF-RT was associated with significantly better LC and OS in patients with KPS ≤70 and unifocal glioblastoma, and with OS in the entire cohort. Trends were found for LC and OS in patients aged <60 years, and for OS in additional four subgroups. On multivariable analyses, improved LC and OS were significantly associated with CF-RT, KPS 80-100, unifocal glioblastoma, resection, and receipt of chemotherapy. Maximum diameter <45 mm was associated with improved OS.

CONCLUSION

Given the limitations of this study, CF-RT appeared associated with better outcomes. Selected patients may benefit from HF-RT.

摘要

背景/目的：低分割放疗（HF-RT）越来越多地用于老年和体弱的胶质母细胞瘤患者。在放射治疗能力有限的国家，HF-RT 的应用更为广泛。这使我们能够比较任何年龄和表现状态的患者的常规分割放疗（CF-RT）与 HF-RT。

患者和方法

我们回顾性分析了 277 例患者[110 例 HF-RT（52.5Gy 分 15 次）与 167 例 CF-RT（54.0-60.0Gy 分 27-33 次）]的局部控制率（LC）和总生存率（OS），包括考虑特定患者特征的亚组。

结果

单变量比较显示，在 KPS≤70 和单灶性胶质母细胞瘤的患者中，CF-RT 与 LC 和 OS 显著相关，在整个队列中与 OS 显著相关。在年龄<60 岁的患者中发现了 LC 和 OS 的趋势，在另外四个亚组中发现了 OS 的趋势。多变量分析显示，LC 和 OS 的改善与 CF-RT、KPS 80-100、单灶性胶质母细胞瘤、切除和化疗的应用显著相关。最大直径<45mm 与 OS 的改善相关。