# One trial randomly assigned 85 patients 70 years of age or older (median, 73 years; range, 70 to 85) to either postoperative radiotherapy (50.4 Gy in 28 fractions) plus supportive care or

A subsequent phase III trial showed noninferiority of 25 Gy in 5 fractions compared to the commonly used 40 Gy in 15 fractions regimen with median survivals of 7.9 vs 6.4 mo, respectively, and no difference in quality of life outcomes. 40 These data clearly support shortened radiation courses for elderly patients; however, hypofractionation as a method of escalating dose is not yet proven.

There are consistent reports of high local control when using 45 Gy in 25 fractions for non -functioning pituitary adenomas ( Erridge 2009). 2017-06-10 Results Fourteen patients received SRS with a median dose of 25 Gy (range, 20-32 Gy) in 1-5 fractions. Twenty-two patients received HSRT with a median dose of 40 Gy (range, 31.5-52 Gy) in 6-20 fractions. There were six treatment-related grade 3 adverse events. Survival analysis showed that 50 Gy to PTV1 10 Gy to PTV2: 25 fractions to PTV1 5 fractions to PTV2: Central/infield 80.9% Marginal 5.7% Distant 13.3%: Median survival 14.2 mo Median time to recurrence 7.5 mo 1 … Even shorter fractionation schedules, such as 34 Gy in 3.4‐Gy fractions or 25 Gy in 5‐Gy fractions, can also be considered, especially in extremely frail patients. 63 It should be noted, however, that those trials did not contain control arms with standard, long‐course, concurrent chemoradiation. between the two treatment regimens in elderly and/or frail patients with glioblastoma multiforme while demonstrating no increase in toxicity for a shorter fractionated regimen (25 Gy in 5 daily fractions) and similar quality of life between the two regimens.

3 Abstract Purpose: Improvements in mortality rate of glioblastoma patients have RT is delivered over the course of six weeks as Gy divided over fractions [2]. 25 Gy D mean 45 Gy D 5% 55 Gy D mean 26 Gy 5 Gy D mean Gy D % 7.3 Gy D Pamorelin (triptorelin) 3,75, 11,25 och 22,5 mg, pulver och vätska till injektionsvätska, två Gy och efter avslutad strålbehandling erhöll patienterna tion) klass III eller IV hjärtsvikt förutom om LVEF (Left Ventricular Ejection Fraction). ≥ 45 % Flourescence-guided resection of glioblastoma multiforme by. As per the date of this Merger Plan, MPI has 5 employ- ees, including MPI's Oncology Ventures företrädesemission (den 25 janu- ari 2018) till den cology Venture being entitled to a fraction of a share in gy Ventures relationer med såväl presumtiva kunder som leverantörer är 2X-111. Glioblastoma. 7.3.5.

7. 5.

## Glioblastoma is a fatal illness progressive disease was defined as a new lesion or an increase by 25% or more 70 to 85) to either postoperative radiotherapy (50.4 Gy in 28 fractions)

DiscussionIn a previous report we showed that accelerated SIB IMRT to a dose of 65 Gy in 25 fractions (BED for glioblastoma = 83.0 Gy, and EQD2 for normal brain = 72.9 Gy) was well tolerated with concurrent and sequential TMZ at standard dose [27]. 9 Nov 2020 volume (PTV) and 25 Gy to the PTV-boost (T1 MRI contrast enhanced area) in 5 daily fractions to the isodose of 67% (maximum dose within The molecular assessment of glioblastoma in elderly patients is not One would need to be very careful with the use of 25 Gy in 5 fractions, as there would be a Currently, 60 Gy to 66 Gy in daily fractions of 2 Gy remains the most common schedule. Principles and Tenets of Radiation Treatment in Glioblastoma an even more hypofractionated course of RT (25 Gy in 5 fractions) was compared wi doses of 16.5-25 Gy a 70-95% local control rate can be after 1995, 25 Gy in 5- Gy daily fractions in this group of selected pts with GBM. Furthermore,. Doses to the large brain metastases were as follows: level I, 18e22 Gy/three fractions or 21e25 Gy/five fractions; level II,. 22e27 Gy/three fractions or 25e31 The incidence of glioblastoma (GBM) in the elderly population is slowly increasing Gy over 6 weeks) and hypofractionated RT (25–40 Gy in 5–15 daily fractions).

### 1 Mar 2019 50.4 Gy in 28 fractions.5 A second randomisation tested the role of two axilla, SCF and internal mammary chain, dose 50 Gy in 25 fractions.28 It temozolomide to radiotherapy for newly diagnosed glioblastoma has been

With 98 patients enrolled, there were no reported differences in OS between the two groups: the 25 Gy cohort had a median OS of 7.9 months and the 40 Gy cohort had a median survival of 6.4 months (P=0.988). In a subsequent prospective randomized trial by the same group, an even more hypofractionated course of RT (25 Gy in 5 fractions) was compared with 40 Gy in 15 fractions. 35 The study included elderly (≥65 years old) and frail patients (age 2015-09-21 · Treatment consisted of a total dose of 25 Gy in five daily fractions (dose/fraction = 5.00 Gy) over 1 week in arm 1 and 40.05 Gy in 15 daily fractions (dose/fraction = 2.67 Gy) over 3 weeks in arm 2. Verification of all treatment fields on the first day of treatment was mandatory and was then performed weekly. Even shorter fractionation schedules, such as 34 Gy in 3.4‐Gy fractions or 25 Gy in 5‐Gy fractions, can also be considered, especially in extremely frail patients. 63 It should be noted, however, that those trials did not contain control arms with standard, long‐course, concurrent chemoradiation. 4.4.5 Fractionation has been governed by tolerance of the local structures and prospective data is lacking.

4.5. 8.9 ‐ ‐ ‐ Roa 2015 a (elderly and non‐frail) Age ≥ 65. KPS ≥ 80%. RT (25 Gy/5 fractions/1 week) 8.0.

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5. Inledning.

with 25 Gy in 5 fractions (23). The trial included newly diagnosed glioblastoma aged 65 years or older and patients aged 50 years or older with a Karnofsky performance score (KPS) of 50–70. With 98 patients enrolled, there were no reported differences in OS between the two groups: the 25 Gy cohort had a median OS of 7.9 months and the 40 Gy
2020-01-31
More recently, Roa et al. investigated short-course radiation therapy (40 Gy in 15 fractions) compared to ultra-hypofractionated radiation therapy (25 Gy in 5 fractions) in elderly/frail patients with glioblastoma.

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### with fraction sizes ranging from 2.4 Gy to 7.25 Gy with Two important aspects of the fractionation scheme and external beam radiotherapy and #9.5 Gy with high-dose- technique need to be discussed. First is the presumed equiv- rate implants (16, 22–27).

No differences in OS, PFS, or quality of life were observed between the two arms. Roa et al.

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### (60 Gy over 6 weeks) and hypofractionated RT (25–40 Gy in 5–15 daily fractions). Temozolomide, an alkylating agent, may represent an effective and safe therapy in patients with promoter methylation of O6-methylguanine-DNA-methyltransferase (MGMT) gene which …

17 The HRT regime of 36 Gy in 6 fractions or 40 Gy in 15 fractions are most commonly employed, but the alternative regime of 25 Gy in five fractions is an attractive option based on the results from the recent … Introduction Rationale. Globally, glioblastoma multiforme (GBM) is one of the most common malignant neoplasms and it generally has a poor prognosis ().Despite advances in the management of GBM, the median overall survival (OS) is <18 months (2, 3).The standard treatment of GBM is to provide 60 Gy of fraction radiotherapy, with 1.8–2.0 Gy per fraction, over a period of 6 weeks with concurrent Given the significant OS advantage of a combined modality regimen, short-course regimens of RT alone (40 Gy in 15 fractions, 34 Gy in 10 or 25 Gy in 5 fractions) should be reserved for elderly and Introduction. Glioblastoma (GBM) is the most common primary brain tumor in adults and often occurs in patients over 65 years of age ().Historically, the treatment for GBM had consisted of maximal safe resection followed by an adjuvant nitrosurea, with trials by the Brain Tumor Study Group demonstrating evidence for post-op RT over best supportive care (2, 3). (60 Gy over 6 weeks) and hypofractionated RT (25–40 Gy in 5–15 daily fractions). Temozolomide, an alkylating agent, may represent an effective and safe therapy in patients with promoter methylation of O6-methylguanine-DNA-methyltransferase (MGMT) gene which … 50 Gy to PTV1 10 Gy to PTV2 25 fractions to PTV1 5 fractions to PTV2 Central/infield 80.9% Marginal 5.7% Distant 13.3% Median survival 14.2 mo Median time to recurrence 7.5 mo 1-y OS 66% 1-y PFS 30% Chang12 Retrospective 48 3D-CRT PTV1 = T1+2.5 cm PTV2 = T1+0.5 cm 50 Gy to PTV1 10 Gy to PTV2 25 fractions to PTV1 5 fractions to PTV2 Central population to a mean dose of 2.2 Gy over 30 fractions (0.5 Gy is lymphotoxic) – Marked reduction in treated volume was the only factor associated with lowering the lymphocytopenic dose • Protons with steep dose gradients and almost no exit dose represent a unique modality to reduce treated volume.

## 13 Aug 2020 After being diagnosed with glioblastoma, an aggressive brain tumor, Stratton Muhmel refused to give up. He enrolled in an experimental new

n = 25. Monjazeb et al. [ 23 ]. GTV + 5 mm. 2.5 Gy. 28.

There was no grade ≥3 toxicity, and no patient required a re-resection due to toxicity(20). Shepherd et al. reported hypofractionated stereotactic radiotherapy in treatment of Treatment consisted of a total dose of 25 Gy in ﬁve daily fractions (dose/fraction 5.00 Gy) over 1 week in arm 1 and 40.05 Gy in 15 daily fractions (dose/fraction 2.67 Gy) over 3 weeks in arm 2. Veriﬁcation of all treatment ﬁelds on the ﬁrst day of treatment was mandatory and was then 50 Gy to PTV1 10 Gy to PTV2: 25 fractions to PTV1 5 fractions to PTV2: Central/infield 80.9% Marginal 5.7% Distant 13.3%: Median survival 14.2 mo Median time to recurrence 7.5 mo 1-y OS 66% 1-y PFS 30%: Chang Glioblastoma is a fatal illness progressive disease was defined as a new lesion or an increase by 25% or more 70 to 85) to either postoperative radiotherapy (50.4 Gy in 28 fractions) randomised patients between 60 Gy in 30 fractions versus 45 Gy in 20 fractions found that the survival HR was 1.0 (95% CI, 0.54–1.89)16, suggesting that a shorter course of radiation may be appropriate for this cohort of patients. More recently, the NOA-08 study17 randomised 412 patients to standard radiation alone of 60 Gy in 30 fractions Search Results Short Course Chemo-Radiation Therapy for Patients With Newly Diagnosed Glioblastoma Study Purpose This is a prospective, randomized, open-label, exploratory trial of temozolomide-based chemo-radiotherapy which compares two widely used established radiation schedules with either 40 Gy in 15 fractions or 25 Gy in 5 fractions with concurrent temozolomide for both schedules in Scoccianti et al. found that 40 patients treated with HFR (45 Gy in 10 fractions) with concurrent adjuvant TMZ, had a median OS of 15.1 months, and a median PFS of 8.6 months. Roa et al., conducted a Phase III trial that compared HFR (40 Gy in 15 fractions) to CFR (25 Gy in 5 fractions).