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Role of Hyperbaric Oxygenation Plus Hypofractionated Stereotactic Radiotherapy in Recurrent High-Grade Glioma.

Authors :
Arpa, Donatella
Parisi, Elisabetta
Ghigi, Giulia
Cortesi, Annalisa
Longobardi, Pasquale
Cenni, Patrizia
Pieri, Martina
Tontini, Luca
Neri, Elisa
Micheletti, Simona
Ghetti, Francesca
Monti, Manuela
Foca, Flavia
Tesei, Anna
Arienti, Chiara
Sarnelli, Anna
Martinelli, Giovanni
Romeo, Antonio
Source :
Frontiers in Oncology; 3/30/2021, Vol. 11, pN.PAG-N.PAG, 9p
Publication Year :
2021

Abstract

Background: The 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. Methods: We 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. Results: Median 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. Conclusions: HSRT 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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
2234943X
Volume :
11
Database :
Complementary Index
Journal :
Frontiers in Oncology
Publication Type :
Academic Journal
Accession number :
149970199
Full Text :
https://doi.org/10.3389/fonc.2021.643469