Wilson Roa1, Penny Brasher1, Glenn Bauman1, Margaret Anthes1, Éduardo Bruera1, A CHAN1, B. Fisher1, Dorcas Fulton1, Sunil Gulavita1, Chuan‐Ming Hao1, Salina Husain1, Albert Murtha1, Kenneth C. Petruk1, Donna E. Stewart1, Peter Tai1, Raul C. Urtasun1, J. G. Cairncross1, Peter Forsyth1
1From the Cross Cancer Institute; Division of Epidemiology, Prevention and Screening, Alberta Cancer Board; Departments of Oncology, Laboratory Medicine and Pathology, and Surgery, University of Alberta, Edmonton; Departments of Oncology and Clinical Neurosciences, University of Calgary and Tom Baker Cancer Center, Calgary, Alberta; London Regional Cancer Center, London; Northwestern Regional Cancer Center, Thunder Bay, Ontario, Canada; and M.D. Anderson Cancer Center, Houston, TX
Tóm tắt
Purpose To prospectively compare standard radiation therapy (RT) with an abbreviated course of RT in older patients with glioblastoma multiforme (GBM). Patients and Methods One hundred patients with GBM, age 60 years or older, were randomly assigned after surgery to receive either standard RT (60 Gy in 30 fractions over 6 weeks) or a shorter course of RT (40 Gy in 15 fractions over 3 weeks). The primary end point was overall survival. The secondary end points were proportionate survival at 6 months, health-related quality of life (HRQoL), and corticosteroid requirement. HRQoL was assessed using the Karnofsky performance status (KPS) and Functional Assessment of Cancer Therapy-Brain (FACT-Br). Results All patients had died at the time of analysis. Overall survival times measured from randomization were similar at 5.1 months for standard RT versus 5.6 months for the shorter course (log-rank test, P = .57). The survival probabilities at 6 months were also similar at 44.7% for standard RT versus 41.7% for the shorter course (lower-bound 95% CI, −13.7). KPS scores varied markedly but were not significantly different between the two groups (Wilcoxon test, P = .63). Low completion rates of the FACT-Br (45%) precluded meaningful comparisons between the two groups. Of patients completing RT as planned, 49% of patients (standard RT) versus 23% required an increase in posttreatment corticosteroid dosage (χ2 test, P = .02). Conclusion There is no difference in survival between patients receiving standard RT or short-course RT. In view of the similar KPS scores, decreased increment in corticosteroid requirement, and reduced treatment time, the abbreviated course of RT seems to be a reasonable treatment option for older patients with GBM.
