Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: A prospective randomized clinical trial

Wilson Roa, P. M.A. Brasher, G. Bauman, M. Anthes, E. Bruera, A. Chan, B. Fisher, D. Fulton, S. Gulavita, Chunhai Hao, S. Husain, A. Murtha, K. Petruk, D. Stewart, P. Tai, R. Urtasun, J. G. Cairncross, P. Forsyth

Research output: Contribution to journalArticle

486 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1583-1588
Number of pages6
JournalJournal of Clinical Oncology
Volume22
Issue number9
DOIs
StatePublished - Dec 1 2004
Externally publishedYes

Fingerprint

Glioblastoma
Radiotherapy
Randomized Controlled Trials
Karnofsky Performance Status
Survival
Adrenal Cortex Hormones
Brain Neoplasms
Quality of Life
Therapeutics
Random Allocation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Abbreviated course of radiation therapy in older patients with glioblastoma multiforme : A prospective randomized clinical trial. / Roa, Wilson; Brasher, P. M.A.; Bauman, G.; Anthes, M.; Bruera, E.; Chan, A.; Fisher, B.; Fulton, D.; Gulavita, S.; Hao, Chunhai; Husain, S.; Murtha, A.; Petruk, K.; Stewart, D.; Tai, P.; Urtasun, R.; Cairncross, J. G.; Forsyth, P.

In: Journal of Clinical Oncology, Vol. 22, No. 9, 01.12.2004, p. 1583-1588.

Research output: Contribution to journalArticle

Roa, W, Brasher, PMA, Bauman, G, Anthes, M, Bruera, E, Chan, A, Fisher, B, Fulton, D, Gulavita, S, Hao, C, Husain, S, Murtha, A, Petruk, K, Stewart, D, Tai, P, Urtasun, R, Cairncross, JG & Forsyth, P 2004, 'Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: A prospective randomized clinical trial', Journal of Clinical Oncology, vol. 22, no. 9, pp. 1583-1588. https://doi.org/10.1200/JCO.2004.06.082
Roa, Wilson ; Brasher, P. M.A. ; Bauman, G. ; Anthes, M. ; Bruera, E. ; Chan, A. ; Fisher, B. ; Fulton, D. ; Gulavita, S. ; Hao, Chunhai ; Husain, S. ; Murtha, A. ; Petruk, K. ; Stewart, D. ; Tai, P. ; Urtasun, R. ; Cairncross, J. G. ; Forsyth, P. / Abbreviated course of radiation therapy in older patients with glioblastoma multiforme : A prospective randomized clinical trial. In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 9. pp. 1583-1588.
@article{cf48d4c75df44a5f88cd03c06ab3f008,
title = "Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: A prospective randomized clinical trial",
abstract = "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.",
author = "Wilson Roa and Brasher, {P. M.A.} and G. Bauman and M. Anthes and E. Bruera and A. Chan and B. Fisher and D. Fulton and S. Gulavita and Chunhai Hao and S. Husain and A. Murtha and K. Petruk and D. Stewart and P. Tai and R. Urtasun and Cairncross, {J. G.} and P. Forsyth",
year = "2004",
month = "12",
day = "1",
doi = "10.1200/JCO.2004.06.082",
language = "English (US)",
volume = "22",
pages = "1583--1588",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "9",

}

TY - JOUR

T1 - Abbreviated course of radiation therapy in older patients with glioblastoma multiforme

T2 - A prospective randomized clinical trial

AU - Roa, Wilson

AU - Brasher, P. M.A.

AU - Bauman, G.

AU - Anthes, M.

AU - Bruera, E.

AU - Chan, A.

AU - Fisher, B.

AU - Fulton, D.

AU - Gulavita, S.

AU - Hao, Chunhai

AU - Husain, S.

AU - Murtha, A.

AU - Petruk, K.

AU - Stewart, D.

AU - Tai, P.

AU - Urtasun, R.

AU - Cairncross, J. G.

AU - Forsyth, P.

PY - 2004/12/1

Y1 - 2004/12/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=2442659387&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2442659387&partnerID=8YFLogxK

U2 - 10.1200/JCO.2004.06.082

DO - 10.1200/JCO.2004.06.082

M3 - Article

C2 - 15051755

AN - SCOPUS:2442659387

VL - 22

SP - 1583

EP - 1588

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 9

ER -