Re-Irradiation for Recurrent Gliomas: Treatment Outcomes and Prognostic Factors.
10.3349/ymj.2016.57.4.824
- Author:
Jeongshim LEE
1
;
Jaeho CHO
;
Jong Hee CHANG
;
Chang Ok SUH
Author Information
1. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea. cosuh317@yuhs.ac
- Publication Type:Original Article
- Keywords:
Re-irradiation;
recurrent glioma;
survival;
prognostic factor
- MeSH:
Adult;
Brain Neoplasms/mortality/*radiotherapy/surgery;
Female;
Glioma/mortality/*radiotherapy/surgery;
Humans;
Karnofsky Performance Status;
Male;
Middle Aged;
Multivariate Analysis;
Neoplasm Recurrence, Local/mortality/*radiotherapy/surgery;
*Re-Irradiation;
Retrospective Studies;
Salvage Therapy;
Treatment Outcome;
Young Adult
- From:Yonsei Medical Journal
2016;57(4):824-830
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of this study was to evaluate the efficacy of re-irradiation in patients with recurrent gliomas and to identify subgroups for whom re-irradiation for recurrent gliomas is most beneficial. MATERIALS AND METHODS: We retrospectively reviewed 36 patients with recurrent or progressive gliomas who received re-irradiation between January 1996 and December 2011. Re-irradiation was offered to recurrent glioma patients with good performance or at least 6 months had passed after initial radiotherapy (RT), with few exceptions. RESULTS: Median doses of re-irradiation and initial RT were 45.0 Gy and 59.4 Gy, respectively. The median time interval between initial RT and re-irradiation was 30.5 months. Median overall survival (OS) and the 12-month OS rate were 11 months and 41.7%, respectively. In univariate analysis, Karnofsky performance status (KPS) ≥70 (p<0.001), re-irradiation dose ≥45 Gy (p=0.040), and longer time interval between initial RT and re-irradiation (p=0.040) were associated with improved OS. In multivariate analysis, KPS (p=0.030) and length of time interval between initial RT and re-irradiation (p=0.048) were important predictors of OS. A radiographically suspected mixture of radiation necrosis and progression after re-irradiation was seen in 5 patients. CONCLUSION: Re-irradiation in conjunction with surgery could be a salvage treatment for selected recurrent glioma patients with good performance status and recurrence over a long time.
