Heavy Ion Radiotherapy Department, Wuwei Cancer Hospital & Institute, Wuwei Academy of Medical Sciences, No. 31 Sanitary Lane, Haizang Road, Wuwei, 733000, Gansu Province, China.
Department of Radiation Oncology, Peking University Third Hospital, Beijing, 100191, China.
BMC Cancer. 2024 Jul 13;24(1):837. doi: 10.1186/s12885-024-12606-x.
This study aimed to compare the survival outcome and side effects in patients with primary high-grade glioma (HGG) who received carbon ion radiotherapy (CIRT) alone or as a boost strategy after photon radiation (photon + CIRT).
Thirty-four (34) patients with histologically confirmed HGG and received CIRT alone or Photon + CIRT with concurrent temozolomide between 2020.03-2023.08 in Wuwei Cancer Hospital & Institute, China were retrospectively reviewed. Overall survival (OS), progression-free survival (PFS), and acute and late toxicities were analyzed and compared.
Eight WHO grade 3 and 26 grade 4 patients were included in the analysis. The median PFS in the CIRT alone and Photon + CIRT groups were 15 and 19 months respectively for all HGG cases, and 15 and 17.5 months respectively for grade 4 cases. The median OS in the CIRT alone and Photon + CIRT groups were 28 and 31 months respectively for all HGG cases, and 21 and 19 months respectively for grade 4 cases. No significant difference in these survival outcomes was observed between the CIRT alone and Photon + CIRT groups. Only grade 1 acute toxicities were observed in CIRT alone and Photon + CIRT groups. CIRT alone group had a significantly lower ratio of acute toxicities compared to Photon + CIRT (3/18 vs. 9/16, p = 0.03). No significant difference in late toxicities was observed.
Both CIRT alone and Photon + CIRT with concurrent temozolomide are safe, without significant differences in PFS and OS in HGG patients. It is meaningful to explore whether dose escalation of CIRT might improve survival outcomes of HGG patients in future randomized trials.
本研究旨在比较接受碳离子放疗（CIRT）单独治疗或在光子放疗（photon+CIRT）后作为增敏策略治疗的原发性高级别胶质瘤（HGG）患者的生存结局和副作用。
回顾性分析了 2020 年 3 月至 2023 年 8 月在中国武威肿瘤医院和研究所接受 CIRT 单独或 photon+CIRT 联合替莫唑胺治疗的 34 例组织学证实的 HGG 患者。分析并比较了总生存期（OS）、无进展生存期（PFS）以及急性和迟发性毒性。
8 例 WHO 分级 3 级，26 例 WHO 分级 4 级患者纳入分析。CIRT 单独治疗和 photon+CIRT 组所有 HGG 患者的中位 PFS 分别为 15 个月和 19 个月，4 级患者分别为 15 个月和 17.5 个月。CIRT 单独治疗和 photon+CIRT 组所有 HGG 患者的中位 OS 分别为 28 个月和 31 个月，4 级患者分别为 21 个月和 19 个月。CIRT 单独治疗和 photon+CIRT 组之间未观察到这些生存结果存在显著差异。CIRT 单独治疗和 photon+CIRT 组仅观察到 1 级急性毒性。CIRT 单独治疗组急性毒性发生率明显低于 photon+CIRT 组（3/18 比 9/16，p=0.03）。两组迟发性毒性无显著差异。
CIRT 单独治疗和 photon+CIRT 联合替莫唑胺治疗均安全，HGG 患者的 PFS 和 OS 无显著差异。在未来的随机试验中探索 CIRT 剂量递增是否能改善 HGG 患者的生存结局具有重要意义。
