{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:14:23Z","timestamp":1778649263658,"version":"3.51.4"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal management for newly diagnosed glioblastoma (GBM) patients with poor prognostic features, such as RPA class IV-VI or rapid early progression, remains debated. This study evaluated the efficacy and safety of postoperative hypofractionated radiotherapy (HFRT) with concurrent temozolomide in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-institution retrospective analysis (Jan 2021-Aug 2025) included patients with histologically confirmed GBM and RPA class IV-VI or rapid early progression who completed postoperative HFRT (\u22653 Gy\/fraction) with concurrent temozolomide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 18 eligible patients, most had unfavorable characteristics (subtotal resection: 66.7%, biopsy-only: 33.3%). With a median follow-up of 22.3 months, the median progression-free survival was 8.4 months and median overall survival was 17.7 months. The disease control rate was 77.8%. Recurrence patterns were in-field (46.2%), marginal (38.5%), and out-of-field (15.4%). Acute grade \u22653 toxicities occurred in 16.7% of patients, all managed conservatively. No radiation necrosis was observed. Corticosteroid dependence occurred in 44.4% of patients but was manageable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this exploratory single-center retrospective study, individually tailored HFRT with concurrent temozolomide demonstrated promising survival outcomes and controllable toxicity in poor-prognosis GBM patients unsuitable for standard therapy. The recurrence pattern observed in this small sample cohort suggests a potential need for optimized target volume delineation for HFRT in this population. HFRT represents a potential viable therapeutic alternative in this challenging population, warranting further large-sample prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1782296","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:44:20Z","timestamp":1778647460000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of hypofractionated radiotherapy combined with temozolomide in patients with newly diagnosed glioblastoma with poor prognosis: a single-center retrospective analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Fangmeng","family":"Fu","sequence":"first","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Ma","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengming","family":"Lan","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Chen","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teng","family":"Zou","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Lei","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renba","family":"Liang","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manyi","family":"Zhu","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianghu","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Shenzhen, China"]},{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nou223","article-title":"CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011","volume":"16","author":"Ostrom","year":"2014","journal-title":"Neuro Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1002\/ana.22425","article-title":"Current concepts and management of glioblastoma","volume":"70","author":"Preusser","year":"2011","journal-title":"Ann Neurol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"iii1","DOI":"10.1093\/neuonc\/noab200","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018","volume":"23","author":"Ostrom","year":"2021","journal-title":"Neuro Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.18718","article-title":"Effect of tumor-treating fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: A randomized clinical trial","volume":"318","author":"Stupp","year":"2017","journal-title":"JAMA"},{"key":"B5","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/bf00167068","article-title":"Prognostic factors for high-grade Malignant glioma: development of a prognostic index. A Report of the Medical Research Council Brain Tumour Working Party","volume":"9","year":"1990","journal-title":"J Neuro-Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(09)70025-7","article-title":"Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial","volume":"10","author":"Stupp","year":"2009","journal-title":"Lancet Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-019-03175-2","article-title":"Hypofractionated radiation therapy versus chemotherapy with temozolomide in patients affected by RPA class V and VI glioblastoma: a randomized phase II trial","volume":"143","author":"Pedretti","year":"2019","journal-title":"J Neuro-Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217881","article-title":"Hypofractionated radiation therapy and temozolomide in patients with glioblastoma and poor prognostic factors. A prospective, single-institution experience","volume":"14","author":"Jablonska","year":"2019","journal-title":"PloS One"},{"key":"B9","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1177\/0300891618792483","article-title":"Phase II study of hypofractionated radiation therapy in elderly patients with newly diagnosed glioblastoma with poor prognosis","volume":"105","author":"Navarria","year":"2019","journal-title":"Tumori"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11111145","article-title":"Poor-prognosis patients affected by glioblastoma: retrospective study of hypofractionated radiotherapy with simultaneous integrated boost and concurrent\/adjuvant temozolomide","volume":"11","author":"Gregucci","year":"2021","journal-title":"J Pers Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(89)90941-3","article-title":"Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma","volume":"16","author":"Wallner","year":"1989","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.30.9.907","article-title":"Assumptions in the radiotherapy of glioblastoma","volume":"30","author":"Hochberg","year":"1980","journal-title":"Neurology"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/83827377","article-title":"Hypofractionated radiotherapy for glioblastoma: strategy for poor-risk patients or hope for the future","volume":"85","author":"Hingorani","year":"2012","journal-title":"Br J Radiol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.canrad.2020.08.049","article-title":"The efficacy of hypofractionated radiotherapy (HFRT) with concurrent and adjuvant temozolomide in newly diagnosed glioblastoma: A meta-analysis","volume":"25","author":"Guo","year":"2021","journal-title":"Cancer Radiother"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1200\/jop.2016.018937","article-title":"Radiation therapy for glioblastoma: american society of clinical oncology clinical practice guideline endorsement of the american society for radiation oncology guideline","volume":"35","author":"Sulman","year":"2017","journal-title":"J Clin Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15235650","article-title":"Hypofractionation in glioblastoma: an overview of palliative, definitive, and exploratory uses","volume":"15","author":"Jiang","year":"2023","journal-title":"Cancers (Basel)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.9.704","article-title":"Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group Malignant glioma trials","volume":"85","author":"Curran","year":"1993","journal-title":"J Natl Cancer Inst"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3765","article-title":"A neurocentric perspective on glioma invasion","volume":"15","author":"Cuddapah","year":"2014","journal-title":"Nat Rev Neurosci"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1782296\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:44:32Z","timestamp":1778647472000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1782296\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":18,"alternative-id":["10.3389\/fonc.2026.1782296"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1782296","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"article-number":"1782296"}}