Comparative Outcomes of Standard Radiation Therapy and 5-Fraction Adaptive Stereotactic Radiation Therapy in Newly Diagnosed Glioblastoma: A Propensity Score–Matched Analysis

作者：Michael Dohopolski, Luiza Giuliani Schmitt, J. D. Vis, Thomaz R. Mostardeiro, Soummitra Anand, Michael Youssef, Evan Noch, Elizabeth A. Maher, Matthew Sun, Toral Patel, Ankur Patel, Sam Barnett, MinJae Lee, Viktor Iakovenko, Tsuicheng Chiu, Fan‐Chi Su, Arnold Pompoš, Mu-Han Lin, Xin Cai, Robert Timmerman, Tu Dan, Zabi Wardak · 发表于：Advances in Radiation Oncology · 年份：2025 · DOI：10.1016/j.adro.2025.101813 · 被引用次数：3 · 研究领域：Glioma Diagnosis and Treatment、Advanced Radiotherapy Techniques、Radiomics and Machine Learning in Medical Imaging

Purpose: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults, with poor survival despite advancements in treatment. Adaptive stereotactic radiation therapy (RT) using a magnetic resonance imaging linear accelerator is an emerging approach for patients with newly diagnosed GBM eligible for conventional fractionation. We hypothesize that adaptive stereotactic RT can provide comparable outcomes with conventional fractionation while reducing treatment burden. Methods and Materials: test, Cox proportional hazards models, and Kaplan-Meier survival curves. Results: = .97). Local failure and grade 3 toxicity rates were similar across groups. O6-methylguanine-DNA-methyltransferase unmethylated status, higher Eastern Cooperative Oncology Group scores, and age 60 years were associated with worse progression-free survival and overall survival. Median travel distances were lower in the 5-fraction group, with a median of 220 miles compared with 877.5 (15 fractions) and 1638 miles (30 fractions). Adaptive RT allowed for real-time tumor monitoring but volumetric changes did not correlate with clinical outcomes. Conclusions: Adaptive 5-fraction RT demonstrates comparable survival outcomes with conventional fractionation while reducing treatment-related travel burden. Further prospective studies are needed to validate its role in GBM management.