Hypofractionated Stereotactic Radiation Therapy in Recurrent High-Grade Glioma: A New Challenge.
- Author:
Pierina NAVARRIA
1
;
Anna Maria ASCOLESE
;
Stefano TOMATIS
;
Giacomo REGGIORI
;
Elena CLERICI
;
Elisa VILLA
;
Giulia MAGGI
;
Lorenzo BELLO
;
Federico PESSINA
;
Luca COZZI
;
Marta SCORSETTI
Author Information
- Publication Type:Original Article
- Keywords: Glioma; Radiosurgery; Retreatment
- MeSH: Diagnosis; Disease-Free Survival; Drug Therapy; Follow-Up Studies; Glioma*; Humans; Karnofsky Performance Status; Multivariate Analysis; Radiosurgery; Radiotherapy; Retreatment; Tumor Burden
- From:Cancer Research and Treatment 2016;48(1):37-44
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The aim of this study was to evaluate outcomes of hypofractionated stereotactic radiation therapy (HSRT) in patients re-treated for recurrent high-grade glioma. MATERIALS AND METHODS: From January 2006 to September 2013, 25 patients were treated. Six patients underwent radiation therapy alone, while 19 underwent combined treatment with surgery and/or chemotherapy. Only patients with Karnofsky Performance Status (KPS) > 70 and time from previous radiotherapy greater than 6 months were re-irradiated. The mean recurrent tumor volume was 35 cm3 (range, 2.46 to 116.7 cm3), and most of the patients (84%) were treated with a total dose of 25 Gy in five fractions (range, 20 to 50 Gy in 5-10 fractions). RESULTS: The median follow-up was 18 months (range, 4 to 36 months). The progression-free survival (PFS) at 1 and 2 years was 72% and 34% and the overall survival (OS) 76% and 50%, respectively. No severe toxicity was recorded. In univariate and multivariate analysis extent of resection at diagnosis significantly influenced PFS and OS (p < 0.01). Patients with smaller recurren tumor volume treated had better local control and survival. Indeed, the 2-year PFS was 40% (< or = 50 cm3) versus 11% (p=0.1) and the 2-year OS 56% versus 33% (> 50 cm3), respectively (p=0.26). CONCLUSION: In our experience, HSRT could be a safe and feasible therapeutic option for recurrent high grade glioma even in patients with larger tumors. We believe that a multidisciplinary evaluation is mandatory to assure the best treatment for selected patients. Local treatment should also be considered as part of an integrated approach.
