ArticleRadiation oncology journal2019
National trends in radiation dose escalation for glioblastoma.
Article in Radiation oncology journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 31 citations in OpenAlex.
- Longitudinal analysis of quality of life following treatment with Asunercept plus reirradiation versus reirradiation in progressive glioblastoma patients.Journal of neuro-oncology · 2019Trial
- Optical microscopy predictions of focal recurrence in glioblastoma.Science advances · 2026Article
- Does pattern of 5-aminolevulinic acid (5-ALA) residual intra-operatively predict worse outcome in glioblastoma?Brain & spine · 2026Article
- Initial observations on dose optimization inFrontiers in oncology · 2026Article
- Inhibition of ATR opposes glioblastoma invasion through disruption of cytoskeletal networks and integrin internalization via macropinocytosis.Neuro-oncology · 2024Article
- Article
- Pseudoprogression versus true progression in glioblastoma: what neurosurgeons need to know.Journal of neurosurgery · 2023Review
- Dosimetric evaluation of adult and paediatric brain tumours planned using mask-based cobalt-60 fractionated stereotactic radiotherapy compared to linear accelerator-based volumetric modulated arc therapy.Journal of medical radiation sciences · 2023Article
- Targeting interleukin-13 receptor α2 (IL-13Rα2) for glioblastoma therapy with surface functionalized nanocarriers.Drug delivery · 2022Review
- Peritumoral edema status of glioblastoma identifies patients reaching long-term disease control with specific progression patterns after tumor resection and high-dose proton boost.Journal of cancer research and clinical oncology · 2021Article
- Novel Treatment for Glioblastoma Delivered by a Radiation Responsive and Radiopaque Hydrogel.ACS biomaterials science & engineering · 2021Article
- Targeting Glioma Stem Cells.Neurosurgery clinics of North America · 2021Review
- Improved 3-year survival rates for glioblastoma multiforme are associated with trends in treatment: analysis of the national cancer database from 2004 to 2013.Journal of neuro-oncology · 2020Article
- Post-Operative Accelerated-Hypofractionated Chemoradiation With Volumetric Modulated Arc Therapy and Simultaneous Integrated Boost in Glioblastoma: A Phase I Study (ISIDE-BT-2).Frontiers in oncology · 2020Article
- Survival of glioblastoma treated with a moderately escalated radiation dose-Results of a retrospective analysis.PloS one · 2020Article
- Presentation of treatment effect in glioblastoma after dose-escalation radiation therapy.Oxford medical case reports · 2019Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGlioblastoma (GBM) carries a high propensity for in-field failure despite trimodality management. Past studies have failed to show outcome improvements with dose-escalation. Herein, we examined trends and outcomes associated with dose-escalation for GBM. MATERIALS AND
methodsThe National Cancer Database was queried for GBM patients who underwent surgical resection and external-beam radiation with chemotherapy. Patients were excluded if doses were less than 59.4 Gy; dose-escalation referred to doses ≥66 Gy. Odds ratios identified predictors of dose-escalation. Univariable and multivariable Cox regressions determined potential predictors of overall survival (OS). Propensity-adjusted multivariable analysis better accounted for indication biases.
resultsOf 33,991 patients, 1,223 patients received dose-escalation. Median dose in the escalation group was 70 Gy (range, 66 to 89.4 Gy). The use of dose-escalation decreased from 8% in 2004 to 2% in 2014. Predictors of escalated dose were African American race, lower comorbidity score, treatment at community centers, decreased income, and more remote treatment year. Median OS was 16.2 months and 15.8 months for the standard and dose-escalated cohorts, respectively (p = 0.35). On multivariable analysis, age >60 years, higher comorbidity score, treatment at community centers, decreased education, lower income, government insurance, Caucasian race, male gender, and more remote year of treatment predicted for worse OS. On propensity-adjusted multivariable analysis, age >60 years, distance from center >12 miles, decreased education, government insurance, and male gender predicted for worse outcome.
conclusionDose-escalated radiotherapy for GBM has decreased over time across the United States, in concordance with guidelines and the available evidence. Similarly, this large study did not discern survival improvements with dose-escalation.
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