Non-standard radiotherapy fractionations delay the time to malignant transformation of low-grade gliomas
Grade II gliomas are slowly growing primary brain tumors that affect mostly young patients. Cytotoxic therapies (radiotherapy and/or chemotherapy) are used initially only for patients having a bad prognosis. These therapies are planned following the "maximum dose in minimum time" principle...
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| description | Grade II gliomas are slowly growing primary brain tumors that affect mostly young patients. Cytotoxic therapies (radiotherapy and/or chemotherapy) are used initially only for patients having a bad prognosis. These therapies are planned following the "maximum dose in minimum time" principle, i. e. the same schedule used for high-grade brain tumors in spite of their very different behavior. These tumors transform after a variable time into high-grade gliomas, which significantly decreases the patient's life expectancy. In this paper we study mathematical models describing the growth of grade II gliomas in response to radiotherapy. We find that protracted metronomic fractionations, i.e. therapeutical schedules enlarging the time interval between low-dose radiotherapy fractions, may lead to a better tumor control without an increase in toxicity. Other non-standard fractionations such as protracted or hypoprotracted schemes may also be beneficial. The potential survival improvement depends on the tumor's proliferation rate and can be even of the order of years. A conservative metronomic scheme, still being a suboptimal treatment, delays the time to malignant progression by at least one year when compared to the standard scheme. |
| doi_str_mv | 10.1371/journal.pone.0178552 |
| format | Article |
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Cytotoxic therapies (radiotherapy and/or chemotherapy) are used initially only for patients having a bad prognosis. These therapies are planned following the "maximum dose in minimum time" principle, i. e. the same schedule used for high-grade brain tumors in spite of their very different behavior. These tumors transform after a variable time into high-grade gliomas, which significantly decreases the patient's life expectancy. In this paper we study mathematical models describing the growth of grade II gliomas in response to radiotherapy. We find that protracted metronomic fractionations, i.e. therapeutical schedules enlarging the time interval between low-dose radiotherapy fractions, may lead to a better tumor control without an increase in toxicity. Other non-standard fractionations such as protracted or hypoprotracted schemes may also be beneficial. The potential survival improvement depends on the tumor's proliferation rate and can be even of the order of years. 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Cytotoxic therapies (radiotherapy and/or chemotherapy) are used initially only for patients having a bad prognosis. These therapies are planned following the "maximum dose in minimum time" principle, i. e. the same schedule used for high-grade brain tumors in spite of their very different behavior. These tumors transform after a variable time into high-grade gliomas, which significantly decreases the patient's life expectancy. In this paper we study mathematical models describing the growth of grade II gliomas in response to radiotherapy. We find that protracted metronomic fractionations, i.e. therapeutical schedules enlarging the time interval between low-dose radiotherapy fractions, may lead to a better tumor control without an increase in toxicity. Other non-standard fractionations such as protracted or hypoprotracted schemes may also be beneficial. The potential survival improvement depends on the tumor's proliferation rate and can be even of the order of years. 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radiotherapy fractionations delay the time to malignant transformation of low-grade gliomas</title><author>Henares-Molina, Araceli ; Benzekry, Sebastien ; Lara, Pedro C ; García-Rojo, Marcial ; Pérez-García, Víctor M ; Martínez-González, Alicia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-6b210c17c315af644ba36a46754a6864705cba17575fd042a53e36eb694fe3203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Biology and Life Sciences</topic><topic>Brain</topic><topic>Brain cancer</topic><topic>Brain Neoplasms - pathology</topic><topic>Brain Neoplasms - radiotherapy</topic><topic>Brain tumors</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Cell cycle</topic><topic>Chemotherapy</topic><topic>Cytotoxicity</topic><topic>Delay</topic><topic>Development and progression</topic><topic>Disease Progression</topic><topic>Dose 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Cytotoxic therapies (radiotherapy and/or chemotherapy) are used initially only for patients having a bad prognosis. These therapies are planned following the "maximum dose in minimum time" principle, i. e. the same schedule used for high-grade brain tumors in spite of their very different behavior. These tumors transform after a variable time into high-grade gliomas, which significantly decreases the patient's life expectancy. In this paper we study mathematical models describing the growth of grade II gliomas in response to radiotherapy. We find that protracted metronomic fractionations, i.e. therapeutical schedules enlarging the time interval between low-dose radiotherapy fractions, may lead to a better tumor control without an increase in toxicity. Other non-standard fractionations such as protracted or hypoprotracted schemes may also be beneficial. The potential survival improvement depends on the tumor's proliferation rate and can be even of the order of years. A conservative metronomic scheme, still being a suboptimal treatment, delays the time to malignant progression by at least one year when compared to the standard scheme.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28570587</pmid><doi>10.1371/journal.pone.0178552</doi><tpages>e0178552</tpages><orcidid>https://orcid.org/0000-0002-1697-0453</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biology and Life Sciences Brain Brain cancer Brain Neoplasms - pathology Brain Neoplasms - radiotherapy Brain tumors Cancer therapies Care and treatment Cell cycle Chemotherapy Cytotoxicity Delay Development and progression Disease Progression Dose Fractionation Drug dosages Edema Expansion Fractionation Fractions Genetic transformation Glioma Glioma - pathology Glioma - radiotherapy Gliomas Health aspects Humans Hypoxia Iodine Life expectancy Life span Mathematical analysis Mathematical models Mathematics Medicine and Health Sciences Oncology Ordinary differential equations Patient outcomes Patients Prognosis Radiation therapy Radiotherapy Research and Analysis Methods Schedules Survival Toxicity Transformation Tumors |
| title | Non-standard radiotherapy fractionations delay the time to malignant transformation of low-grade gliomas |
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