The studies on hypo-fractionation for GBM showed 5-12 months median overall survivals not inferior to standard fractionation protocols. We aimed to describe the feasibility of extreme hypo fractionation combined with temozolamide for newly diagnosed and recurrent GBM.
During Dec 2015- Dec 2017, 60 patients of biopsy proven GBM were retrospectively scrutinized and were analysed. PTV was defined on FLAIR/T2 signal coverage with 4 mm margin and GTV was defined as contrast enhanced tumor. PTV was prescribed with 5 Gy (range: 4.5-6 Gy) in five fractions at isocenter and GTV was prescribed as single fraction SRS as 8 Gy (range: 6-12 Gy) at 75% (range: 65-90%) isodose line. Radiation was completed in 8 days. Temozolamide was given as 100mg daily for 8 days.
Mean age was 45 years (range: 22- 74 years). 40(66.66%) patients were male and 20(33.33%) were female. CR was found in 07 (11.66%) patients, PR was seen in 28 (46.66%) patients. SD was observed in 20 (33.33%) patients. 05 (8.33%) had PD during first 3-4 months. Treatment was tolerated very well. Only 5 patients used corticosteroids for 3 months. Median follow-up time was 24 months (range: 08-32 months). Median survival in newly diagnosed patients was 12.5 months (range: 4.5 -16 months), while in recurrent cases it was 8.5 months (range: 3 -11 months).
Extreme hypo-fractionation combined with temozolamide is safe and an effective approach to manage GBM cases and survivals are also comparable to the standard approaches. Further randomized studies are warranted to establish its regular use.
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All authors have declared no conflicts of interest.