The power of three: hypofractionation, protons, and molecular imaging in glioblastoma radiotherapy
Mené sur 39 patients âgés atteints d'un glioblastome (âge médian : 70,2 ans ; 28 % de femmes ; durée médiane de suivi : 25,4 mois), cet essai de phase II évalue l'efficacité, du point de vue de la survie globale à 12 mois, d'un traitement par protonthérapie hypofractionnée et guidée par TEP 18F-Dopa
Résumé en anglais
The groundbreaking study reported by Sujay Vora and colleagues1 in their Article in The Lancet Oncology incorporates three emerging techniques for glioblastoma chemoradiotherapy into a single-arm phase 2 trial. The first technique is hypofractionation, which replaces more frequent radiotherapy sessions with less frequent and higher daily doses. An international trial supported the use of 40 Gy in 15 fractions over 3 weeks with concurrent temozolomide as equivalent to conventional 6-week courses for older patients (age ≥65 years). The current trial continues this trend with so-called extreme hypofractionation, delivering five fractions of radiotherapy over 1 week to T1-weighted contrast-enhancing volumes (30 Gy) and PET-defined volumes (35 Gy) for combined volumes up to 65 cm³. However, notably, grade 3 radiation necrosis was observed in three (17%) of 18 patients receiving these doses, which is higher than expected.
