Evaluating the role of HYpofractionated RAdiotherapy schedule in High Grade GlioMA patients less than 60 years of age during the COVID period- A single Institutional Prospective Observational Study (HYRAMA study)

Purpose: Hypofractionated radiotherapy (HRT) has been offered as an alternative in High Grade Glioma (HGG) patients above the age of 60 years. The aim of the study was to evaluate the role of HRT in patients with HGG aged less than 60 years. Methods: Prospective observation study and HGG patients less than 60 years of age were eligible for the study. HRT regimen was of 40 Gray (Gy) in 15 fractions with Temozolomide (TMZ). The Primary objective was to assess the progression free survival (PFS) while overall survival (OS) and toxicity profile being secondary end points. Results: From April 2021 to April 2022, 15 patients were recruited in the study. The mean age was 44.6 years (28–59 years SD +-9.2), IDH wild type was seen in 10 patients. Most patients (9 patients) underwent a gross tumour excision. The median follow up was 15 months (Range of 7–19 months). The estimated median PFS was 13.5 months (SD ± 1.13; 95% CI 11.23–15.66). On multivariate analysis, only male gender and presence of midline shift were found to affect negatively the PFS. Three patients had disease progression at last follow up. None of the patients reported any Grade 3 or 4 toxicities. Conclusion: The HRT regimen can be an alternative to long course chemoradiation regimen with acceptable PFS and toxicity in patients less than 60 years of age.