Abstract
BackgroundThe presence of hypoxic cells in high-grade glioma (HGG) is one of major reasons for failure of local tumour control with radiotherapy (RT). The use of hyperbaric oxygen therapy (HBO) could help to overcome the problem of oxygen deficiency in poorly oxygenated regions of the tumour. We propose an innovative approach to improve the efficacy of hypofractionated stereotactic radiotherapy (HSRT) after HBO (HBO-RT) for the treatment of recurrent HGG (rHGG) and herein report the results of an ad interim analysis.MethodsWe enrolled a preliminary cohort of 9 adult patients (aged >18 years) with a diagnosis of rHGG. HSRT was administered in daily 5-Gy fractions for 3-5 consecutive days a week. Each fraction was delivered up to maximum of 60 minutes after HBO.ResultsMedian follow-up from re-irradiation was 11.6 months (range: 3.2-11.6 months). The disease control rate (DCR) 3 months after HBO-RT was 55.5% (5 patients). Median progression-free survival (mPFS) for all patients was 5.2 months (95%CI: 1.34-NE), while 3-month and 6-month PFS was 55.5% (95%CI: 20.4-80.4) and 27.7% (95%CI: 4.4-59.1), respectively. Median overall survival (mOS) of HBO-RT was 10.7 months (95% CI: 7.7-NE). No acute or late neurologic toxicity >grade (G)2 was observed in 88.88% of patients. One patient developed G3 radionecrosis.ConclusionsHSRT delivered after HBO appears to be effective for the treatment of rHGG, it could represent an alternative, with low toxicity, to systemic therapies for patients who cannot or refuse to undergo such treatments.Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT 03411408.
Highlights
High-grade gliomas (HGGs) represent the most malignant and most frequently encountered primary brain tumour in clinical neuro-oncology
We propose an innovative approach to improve the efficacy of hypofractionated stereotactic radiotherapy (HSRT) after hyperbaric oxygenation (HBO) (HBO-RT) for the treatment of recurrent HGG and report the results of an ad interim analysis
HSRT delivered after HBO appears to be effective for the treatment of recurrent HGG (rHGG), it could represent an alternative, with low toxicity, to systemic therapies for patients who cannot or refuse to undergo such treatments
Summary
High-grade gliomas (HGGs) represent the most malignant and most frequently encountered primary brain tumour in clinical neuro-oncology. Despite improvements in diagnostic and therapeutic strategies, the clinical prognosis for patients with HGG remains poor, with a median overall survival of
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