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01-12-2020 | Glioblastoma | Review

Survival after hypofractionation in glioblastoma: a systematic review and meta-analysis

Authors: Jane-Chloe Trone, Alexis Vallard, Sandrine Sotton, Majed Ben Mrad, Omar Jmour, Nicolas Magné, Benjamin Pommier, Silvy Laporte, Edouard Ollier

Published in: Radiation Oncology | Issue 1/2020

Abstract

Background

Glioblastoma multiforme (GBM) has a poor prognosis despite a multi modal treatment that includes normofractionated radiotherapy. So, various hypofractionated alternatives to normofractionated RT have been tested to improve such prognosis. There is need of systematic review and meta-analysis to analyse the literature properly and maybe generalised the use of hypofractionation. The aim of this study was first, to perform a meta-analysis of all controlled trials testing the impact of hypofractionation on survival without age restriction and secondly, to analyse data from all non-comparative trials testing the impact of hypofractionation, radiosurgery and hypofractionated stereotactic RT in first line.

Materials/Methods

We searched Medline, Embase and Cochrane databases to identify all publications testing the impact of hypofractionation in glioblastoma between 1985 and March 2020. Combined hazard ratio from comparative studies was calculated for overall survival. The impact of study design, age and use of adjuvant temozolomide was explored by stratification. Meta-regressions were performed to determine the impact of prognostic factors.

Results

2283 publications were identified. Eleven comparative trials were included. No impact on overall survival was evidenced (HR: 1.07, 95%CI: 0.89-1.28) without age restriction. The analysis of non-comparative literature revealed heterogeneous outcomes with limited quality of reporting. Concurrent chemotherapy, completion of surgery, immobilization device, isodose of prescription, and prescribed dose (depending on tumour volume) were poorly described. However, results on survival are encouraging and were correlated with the percentage of resected patients and with patients age but not with median dose.

Conclusions

Because few trials were randomized and because the limited quality of reporting, it is difficult to define the place of hypofactionation in glioblastoma. In first line, hypofractionation resulted in comparable survival outcome with the benefit of a shortened duration. The method used to assess hypofractionation needs to be improved.

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Title: Survival after hypofractionation in glioblastoma: a systematic review and meta-analysis
Authors: Jane-Chloe Trone
Alexis Vallard
Sandrine Sotton
Majed Ben Mrad
Omar Jmour
Nicolas Magné
Benjamin Pommier
Silvy Laporte
Edouard Ollier
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Glioblastoma
Glioblastoma
Radiotherapy
Glioblastoma
Published in: Radiation Oncology / Issue 1/2020
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-020-01584-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Survival after hypofractionation in glioblastoma: a systematic review and meta-analysis

Abstract

Background

Materials/Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials/Methods

Results

Conclusions

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