PMID- 32658268
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210714
IS  - 1523-5866 (Electronic)
IS  - 1522-8517 (Print)
IS  - 1522-8517 (Linking)
VI  - 23
IP  - 3
DP  - 2021 Mar 25
TI  - Pulsed radiation therapy for the treatment of newly diagnosed glioblastoma.
PG  - 447-456
LID - 10.1093/neuonc/noaa165 [doi]
AB  - BACKGROUND: Pulsed radiation therapy (PRT) has shown effective tumor control and 
      superior normal-tissue sparing ability compared with standard radiotherapy (SRT) 
      in preclinical models and retrospective clinical series. This is the first 
      prospective trial to investigate PRT in the treatment of patients with newly 
      diagnosed glioblastoma (GBM). METHODS: This is a single-arm, prospective study. 
      Patients with newly diagnosed GBM underwent surgery, followed by 60 Gy of PRT 
      with concurrent temozolomide (TMZ). Each day, a 2-Gy fraction was divided into 
      ten 0.2-Gy pulses, separated by 3-minute intervals. Patients received maintenance 
      TMZ. Neurocognitive function (NCF) and quality of life (QoL) were monitored for 2 
      years using the Hopkins Verbal Learning Test‒Revised and the European 
      Organisation for Research and Treatment of Cancer QLQ-C30 QoL questionnaire. 
      Change in NCF was evaluated based on a minimal clinically important difference 
      (MCID) threshold of 0.5 standard deviation. RESULTS: Twenty patients were 
      enrolled with a median follow-up of 21 months. Median age was 60 years. Forty 
      percent underwent subtotal resection, and 60% underwent gross total resection. 
      One patient had an isocitrate dehydrogenase (IDH)-mutated tumor. Median 
      progression-free survival (PFS) and overall survival (OS) were 10.7 and 20.9 
      months, respectively. In a post-hoc comparison, median OS for the prospective 
      cohort was longer, compared with a matched cohort receiving SRT (20.9 vs 14 mo, P 
      = 0.042). There was no decline in QoL, and changes in NCF scores did not meet the 
      threshold of an MCID. CONCLUSIONS: Treatment of newly diagnosed GBM with PRT is 
      feasible and produces promising effectiveness while maintaining neurocognitive 
      function and QoL. Validation of our results in a larger prospective trial 
      warrants consideration.
CI  - (c) The Author(s) 2020. Published by Oxford University Press on behalf of the 
      Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: 
      journals.permissions@oup.com.
FAU - Almahariq, Muayad F
AU  - Almahariq MF
AD  - Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan.
FAU - Quinn, Thomas J
AU  - Quinn TJ
AD  - Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan.
FAU - Arden, Jessica D
AU  - Arden JD
AD  - Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan.
FAU - Roskos, P T
AU  - Roskos PT
AD  - Neuropsychology Services, Department of Physical Medicine and Rehabilitation, 
      Beaumont Health, Dearborn, Michigan.
FAU - Wilson, George D
AU  - Wilson GD
AD  - Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan.
AD  - Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan.
FAU - Marples, Brian
AU  - Marples B
AD  - Department of Radiation Oncology, University of Rochester, Rochester, New York.
FAU - Grills, Inga S
AU  - Grills IS
AD  - Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan.
AD  - Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan.
FAU - Chen, Peter Y
AU  - Chen PY
AD  - Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan.
AD  - Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan.
FAU - Krauss, Daniel J
AU  - Krauss DJ
AD  - Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan.
FAU - Chinnaiyan, Prakash
AU  - Chinnaiyan P
AD  - Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan.
FAU - Dilworth, Joshua T
AU  - Dilworth JT
AD  - Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Neuro Oncol
JT  - Neuro-oncology
JID - 100887420
RN  - 0 (Antineoplastic Agents, Alkylating)
SB  - IM
CIN - Neuro Oncol. 2021 Mar 25;23(3):345-346. PMID: 33618364
MH  - Antineoplastic Agents, Alkylating/therapeutic use
MH  - *Brain Neoplasms/drug therapy/radiotherapy
MH  - Chemoradiotherapy
MH  - *Glioblastoma/drug therapy/radiotherapy
MH  - Humans
MH  - Middle Aged
MH  - Prospective Studies
MH  - Quality of Life
MH  - Retrospective Studies
PMC - PMC7992887
OTO - NOTNLM
OT  - glioblastoma
OT  - neurocognitive function
OT  - pulsed radiation therapy
OT  - quality of life
EDAT- 2020/07/14 06:00
MHDA- 2021/04/28 06:00
PMCR- 2021/07/13
CRDT- 2020/07/14 06:00
PHST- 2020/07/14 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/07/14 06:00 [entrez]
PHST- 2021/07/13 00:00 [pmc-release]
AID - 5870764 [pii]
AID - noaa165 [pii]
AID - 10.1093/neuonc/noaa165 [doi]
PST - ppublish
SO  - Neuro Oncol. 2021 Mar 25;23(3):447-456. doi: 10.1093/neuonc/noaa165.