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Abstract：
BACKGROUND: This study aimed to compare the survival outcome and side effects in patients with primary high-grade glioma (HGG) who received carbon ion radiotherapy (CIRT) alone or as a boost strategy after photon radiation (photon + CIRTboost).
METHODS: Thirty-four (34) patients with histologically confirmed HGG and received CIRT alone or Photon + CIRTboost, with concurrent temozolomide between 2020.03-2023.08 in Wuwei Cancer Hospital & Institute, China were retrospectively reviewed. Overall survival (OS), progression-free survival (PFS), and acute and late toxicities were analyzed and compared.
RESULTS: Eight WHO grade 3 and 26 grade 4 patients were included in the analysis. The median PFS in the CIRT alone and Photon + CIRTboost groups were 15 and 19 months respectively for all HGG cases, and 15 and 17.5 months respectively for grade 4 cases. The median OS in the CIRT alone and Photon + CIRTboost groups were 28 and 31 months respectively for all HGG cases, and 21 and 19 months respectively for grade 4 cases. No significant difference in these survival outcomes was observed between the CIRT alone and Photon + CIRTboost groups. Only grade 1 acute toxicities were observed in CIRT alone and Photon + CIRTboost groups. CIRT alone group had a significantly lower ratio of acute toxicities compared to Photon + CIRTboost (3/18 vs. 9/16, p = 0.03). No significant difference in late toxicities was observed.
CONCLUSIONS: Both CIRT alone and Photon + CIRTboost with concurrent temozolomide are safe, without significant differences in PFS and OS in HGG patients. It is meaningful to explore whether dose escalation of CIRTboost might improve survival outcomes of HGG patients in future randomized trials.
METHODS: Thirty-four (34) patients with histologically confirmed HGG and received CIRT alone or Photon + CIRTboost, with concurrent temozolomide between 2020.03-2023.08 in Wuwei Cancer Hospital & Institute, China were retrospectively reviewed. Overall survival (OS), progression-free survival (PFS), and acute and late toxicities were analyzed and compared.
RESULTS: Eight WHO grade 3 and 26 grade 4 patients were included in the analysis. The median PFS in the CIRT alone and Photon + CIRTboost groups were 15 and 19 months respectively for all HGG cases, and 15 and 17.5 months respectively for grade 4 cases. The median OS in the CIRT alone and Photon + CIRTboost groups were 28 and 31 months respectively for all HGG cases, and 21 and 19 months respectively for grade 4 cases. No significant difference in these survival outcomes was observed between the CIRT alone and Photon + CIRTboost groups. Only grade 1 acute toxicities were observed in CIRT alone and Photon + CIRTboost groups. CIRT alone group had a significantly lower ratio of acute toxicities compared to Photon + CIRTboost (3/18 vs. 9/16, p = 0.03). No significant difference in late toxicities was observed.
CONCLUSIONS: Both CIRT alone and Photon + CIRTboost with concurrent temozolomide are safe, without significant differences in PFS and OS in HGG patients. It is meaningful to explore whether dose escalation of CIRTboost might improve survival outcomes of HGG patients in future randomized trials.
摘要：
背景：本研究旨在比较原发性高级别神经胶质瘤（HGG）患者的生存结果和副作用，这些患者单独接受碳离子放疗（CIRT）或作为光子放疗后的增强策略（光子+CIRTboost）。
方法：三十四（34）例经组织学证实的HGG患者，并单独接受CIRT或光子CIRTboost，在2020.03-2023.08期间在武威市肿瘤医院和研究所同时使用替莫唑胺，对中国进行了回顾性审查。总生存期（OS），无进展生存期（PFS），并对急性毒性和晚期毒性进行了分析和比较。
结果：8名WHO3级和26名4级患者被纳入分析。对于所有HGG病例，单独CIRT组和光子CIRTboost组的中位PFS分别为15个月和19个月，4级病例分别为15个月和17.5个月。对于所有HGG病例，单独CIRT组和光子CIRTboost组的中位OS分别为28个月和31个月，4级病例分别为21个月和19个月。在单独的CIRT和光子+CIRTboost组之间没有观察到这些生存结果的显著差异。仅在单独的CIRT和光子CIRTboost组中观察到1级急性毒性。与光子+CIRTboost相比，单纯CIRT组的急性毒性比率显著降低（3/18vs.9/16，p=0.03）。没有观察到晚期毒性的显著差异。
结论：单独使用BothCIRT和光子+CIRTboost同时使用替莫唑胺是安全的，HGG患者的PFS和OS无显著差异。在未来的随机试验中，探讨CIRTboost的剂量递增是否可以改善HGG患者的生存结果是有意义的。
方法：三十四（34）例经组织学证实的HGG患者，并单独接受CIRT或光子CIRTboost，在2020.03-2023.08期间在武威市肿瘤医院和研究所同时使用替莫唑胺，对中国进行了回顾性审查。总生存期（OS），无进展生存期（PFS），并对急性毒性和晚期毒性进行了分析和比较。
结果：8名WHO3级和26名4级患者被纳入分析。对于所有HGG病例，单独CIRT组和光子CIRTboost组的中位PFS分别为15个月和19个月，4级病例分别为15个月和17.5个月。对于所有HGG病例，单独CIRT组和光子CIRTboost组的中位OS分别为28个月和31个月，4级病例分别为21个月和19个月。在单独的CIRT和光子+CIRTboost组之间没有观察到这些生存结果的显著差异。仅在单独的CIRT和光子CIRTboost组中观察到1级急性毒性。与光子+CIRTboost相比，单纯CIRT组的急性毒性比率显著降低（3/18vs.9/16，p=0.03）。没有观察到晚期毒性的显著差异。
结论：单独使用BothCIRT和光子+CIRTboost同时使用替莫唑胺是安全的，HGG患者的PFS和OS无显著差异。在未来的随机试验中，探讨CIRTboost的剂量递增是否可以改善HGG患者的生存结果是有意义的。
