TOPLINE:
Short-course hypofractionated palliative radiation therapy improves quality of life in patients with poor-prognosis, high-grade gliomas.
METHODOLOGY:
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Uncertainty persists about the value of palliative radiation, particularly longer regimens, among patients with high-grade gliomas.
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To address the uncertainty, investigators administered quality of life (QoL) questionnaires to patients before receiving 35 Gy of palliative radiation in 10 fractions over 2 weeks, then again 1 month after treatment, followed by every 3 months until disease progression or death.
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Overall, 49 of 55 patients (89%) completed radiation treatment, and 42 completed the surveys.
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QoL was assessed using the 100-point European Organization for Research and Treatment of Cancer QoL core questionnaire (QLQ-C30) and its brain cancer module (BN20).
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Two thirds of patients were treated with temozolomide chemotherapy following radiation.
TAKEAWAYS:
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There was clinically and statistically significant improvement 1 month after radiation therapy in patient-reported fatigue and dyspnea on the QLQ-C30.
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A clinically meaningful improvement — meaning a 10-point or greater improvement — was also seen for insomnia. Other symptoms, such as nausea/vomiting, loss of appetite, constipation, diarrhea, and financial difficulty, remained stable over time.
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On the BN20, investigators reported clinically and statistically significant improvement in motor function; other symptoms remained stable.
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Median progression-free survival was 8.4 months; median overall survival was 10.5 months.
IN PRACTICE:
“Short-course palliative hypofractionated radiotherapy in patients with poor-prognosis [high-grade glioma] does not impair QoL in the short term; but is rather associated with stable and/or improved QoL scores in several domains/symptom scales” at 1-3 months after treatment, “making it a viable resource-sparing alternative regimen,” the authors concluded.
SOURCE:
The work, led by Y. Baviskar of the Tata Memorial Hospital Department of Radiation Oncology in Mumbai, India, was published July 11 in Clinical Oncology.
LIMITATIONS:
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It was a single-center study with no control arm.
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Fewer patients completed QoL forms over time, limiting longitudinal assessment to 3 months.
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Forms might have been completed by caregivers at times, raising questions about the veracity of responses.
DISCLOSURES:
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There was no external funding for the work.
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The investigators report no relevant financial relationships.
M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who worked for several major news outlets before joining Medscape. Alex is also an MIT Knight Science Journalism fellow. Email: [email protected].
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