For high-grade glioma (HGG) patients with old age or poor performance status, hypofractionated radiotherapy (hypoRT) in 10–15 fractions is recommended. Also, limited data exist on the impact of salvage treatment after progression in frail patients. We retrospectively analyzed the outcomes of dose-escalated hypoRT in 40 frail HGG patients who were treated with hypoRT between 2013 and 2021. With a median biologically effective dose of 71.7 Gy, a total dose of 56 Gy in 20 fractions was the most frequently used regimen (53.7%). The median age and Karnofsky Performance Status of patients were 74 years and 70, respectively. Most patients (n= 31, 77.5%) were diagnosed with glioblastoma, IDH-wildtype, CNS WHO grade 4. Only 10 (25.0%) patients underwent surgical resection, and 28 (70.0%) patients received concurrent temozolomide during hypoRT. With a median follow-up of 9.7 months, the median overall survival (OS) was 12.2 months. Of the 30 (75.0%) patients with disease progression, only 12 patients received salvage treatment. The OS after progression differed significantly depending on salvage treatment (median OS, 9.6 vs. 4.6 months,p= 0.032). Dose-escalated hypoRT in 20 fractions produced survival outcomes outperforming historical data for frail patients.
对于高龄或体能状态较差的高级别胶质瘤患者，推荐采用10-15次分割的大分割放疗方案。目前关于体弱患者疾病进展后挽救性治疗影响的数据较为有限。本研究回顾性分析了2013年至2021年间接受大分割放疗的40例体弱高级别胶质瘤患者接受剂量递增大分割放疗的疗效。中位生物有效剂量为71.7 Gy，其中56 Gy/20次分割是最常用的治疗方案（占53.7%）。患者中位年龄74岁，中位卡氏功能状态评分为70分。大多数患者（31例，77.5%）被诊断为IDH野生型、CNS WHO 4级的胶质母细胞瘤。仅10例（25.0%）患者接受手术切除，28例（70.0%）患者在大分割放疗期间同步接受替莫唑胺治疗。中位随访时间9.7个月，中位总生存期为12.2个月。在30例（75.0%）出现疾病进展的患者中，仅12例接受了挽救性治疗。接受与未接受挽救性治疗患者的进展后生存期存在显著差异（中位总生存期分别为9.6个月 vs 4.6个月，p=0.032）。20次分割的剂量递增大分割放疗方案为体弱患者带来的生存获益优于历史数据。
肿瘤(癌症)患者之家