Improving the acceptability of high-dose radiotherapy by reducing the duration of treatment: accelerated radiotherapy in high-grade glioma
| العنوان: | Improving the acceptability of high-dose radiotherapy by reducing the duration of treatment: accelerated radiotherapy in high-grade glioma |
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| المؤلفون: | Stanley W. Ashley, F Hines, Sean Elyan, S Stenning, BA Bell, N. James, H. Marsh, Michael Brada, G Thomas |
| المصدر: | British Journal of Cancer |
| بيانات النشر: | Springer Science and Business Media LLC, 1995. |
| سنة النشر: | 1995 |
| مصطلحات موضوعية: | Adult, Male, Oncology, Cancer Research, medicine.medical_specialty, Time Factors, Biopsy, medicine.medical_treatment, Context (language use), law.invention, Randomized controlled trial, Actuarial Analysis, law, Internal medicine, medicine, Humans, Prospective Studies, Prospective cohort study, Survival analysis, Aged, Performance status, Brain Neoplasms, business.industry, Hazard ratio, Radiotherapy Dosage, Glioma, Middle Aged, Survival Analysis, Surgery, Radiation therapy, Regimen, Feasibility Studies, Female, business, Research Article |
| الوصف: | Radiotherapy, although clearly beneficial in patients with high-grade glioma, is largely palliative, and a protracted course of treatment may not be the most appropriate approach in the context of limited survival. We therefore assessed the feasibility, toxicity and survival results of a short accelerated radiotherapy regimen given twice daily over a period of 3 weeks. A total of 116 patients with high-grade glioma were treated with radiotherapy in a prospective study using an accelerated fractionation regimen. The total dose of 55 Gy was given in 32-36 fractions of 1.72-1.53 Gy, twice daily 5 days a week, with a minimum 6 h interval between fractions. Toxicity was assessed using Karnofsky performance status scale and in the later part of the study with the Barthel index. Survival data were compared with a control group treated with 60 Gy in 30 daily fractions in a previous MRC study, matched for known prognostic factors. The median survival of 116 patients treated with accelerated radiotherapy was 10 months. Survival comparison of accelerated patients with matched controls treated with conventional fractionation demonstrated a hazard ratio of 1.13 (95% confidence interval 0.85-1.51; P = 0.39). Early treatment toxicity was acceptable, with only seven patients developing transient decrease in performance status. The accelerated radiotherapy regimen was logistically feasible and acceptable to patients, carers and staff. Treatment time was reduced without apparent increase in early toxicity and there was no loss of survival benefit. The effectiveness and convenience of a short accelerated regimen makes this a suitable alternative to a 6 week course of radiotherapy in patients with high-grade glioma. However, a full randomised trial comparing conventional and accelerated radiotherapy may be required as proof of equivalence. |
| تدمد: | 1532-1827 0007-0920 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0878bbcf9caa0578d1cb9c0f7f396d0d https://doi.org/10.1038/bjc.1995.258 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....0878bbcf9caa0578d1cb9c0f7f396d0d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15321827 00070920 |
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