MedicalResearch.com Interview with:
Professor Rakesh Jalali, MD
Professor of Radiation Oncology
President, Indian Society of Neuro-Oncology
Parel, Mumbai India
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Randomized controlled trials to test the efficacy of radiotherapy techniques are challenging to perform. High-precision conformal techniques such as stereotactic radiosurgery/radiotherapy, intensity modulated radiotherapy (IMRT) and particle therapy, etc have been incorporated into routine clinical practice including for brain tumors without always being supported by level-1 evidence.
We therefore conducted a prospective, randomized, controlled trial of stereotactic conformal radiotherapy compared to conventional radiotherapy in young patients with residual/progressive bening and low grade brain tumors requiring radiotherapy for optimal disease control.
MedicalResearch.com: What should readers take away from your report?
Response: Our study provides a very high level of evidence in favou of using modern high precision conformal radiotherapy techniques as compared to conventional radiotherapy in the treatment of residual or progressive benign and low grade brain tumours in young patients, when indicated. The study is unique in the sense that not only is the evidence generated by a prospective randomized trial in an appropriately powered relatively large number of subjects but has used the most clinically meaningful endpoints of preservation of neurocognition and endocrine function at long term in these patients while maintaining high local control and survival in these patients.
The study is among the few ones testing modern radiotherapy techniques in a prospective randomized fashion.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: While the study used stereotactic conformal radiotherapy approach as the study arm, data from the study can potentially act as suitable template for even more precise and conformal radiotherapy techniques in the current clinical practice including for example IMRT and may be even particle beam therapy. All these recent advances are likely to further minimize some of the late sequelae thereby improving the therapeutic ratio, a proof of concept validated by the present randomized study.Suitable studies could be designed accordingly using clinically relevant patient centric endpoints.
MedicalResearch.com: Is there anything else you would like to add?
Response: We are grateful to Tata Memorial Centre, Terry Fox India committee and the Brain Tumour Foundation (BTF) India for the financial support.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Jalali R, Gupta T, Goda JS, Goswami S, Shah N, Dutta D, Krishna U, Deodhar J, Menon P, Kannan S, Sarin R. Efficacy of Stereotactic Conformal Radiotherapy vs Conventional Radiotherapy on Benign and Low-Grade Brain TumorsA Randomized Clinical Trial. JAMA Oncol. Published online June 01, 2017. doi:10.1001/jamaoncol.2017.0997
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