Three-times daily ultrafractionated radiation therapy, a novel and promising regimen for glioblastoma patients

摘要: Glioblastomas are considered to be one of the most radio resistant tumors. Despite new therapies, prognosis this disease remains dismal. Also, mechanisms radiation resistance in mammalian cells more complex than once believed. Experimental studies have indicated that some human cell lines sensitive low doses <1 Gy. This phenomenon has been termed low-dose hyper-radio-sensitivity (HRS), and is apparent lines, such as glioblastoma cells. Sensitivity may result from inability dose efficiently induce repair mechanisms, whereas higher cause enough damage trigger responses for resistance. In vitro demonstrated using various malignant glioma lines: (1) daily repeated irradiation with compared a single biologically equivalent resulted significantly killing; (2) experiments conducted on xenografts was effective inhibiting tumor growth dose. order confirm validate these promising HRS, few phase II trials were developed. For translating experimental observations into clinic, ultra fractionation protocols (with three doses) tested patients. Tolerance toxicity primary endpoints, overall survival secondary endpoint. These initiated before concomitant chemotherapy became standard care. trials, patients an unfavorable clinical prognostic factor newly unresectable GBM included. When comparing results international literature multivariate analysis both progression free survival, fractionated showed superiority over radiotherapy alone. addition, it found treatment temozolomide. Therefore, prolong review, we describe main data regarding hypersensitivity well findings investigated regimen.