TY - JOUR
T1 - Hypofractionated stereotactic radiation therapy in recurrent high-grade glioma
T2 - A new challenge
AU - Navarria, Pierina
AU - Ascolese, Anna Maria
AU - Tomatis, Stefano
AU - Reggiori, Giacomo
AU - Clerici, Elena
AU - Villa, Elisa
AU - Maggi, Giulia
AU - Bello, Lorenzo
AU - Pessina, Federico
AU - Cozzi, Luca
AU - Scorsetti, Marta
PY - 2016
Y1 - 2016
N2 - 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 recurrent tumor volume treated had better local control and survival. Indeed, the 2-year PFS was 40% (<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.
AB - 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 recurrent tumor volume treated had better local control and survival. Indeed, the 2-year PFS was 40% (<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.
KW - Glioma
KW - Radiosurgery
KW - Retreatment
UR - http://www.scopus.com/inward/record.url?scp=84957608412&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84957608412&partnerID=8YFLogxK
U2 - 10.4143/crt.2014.259
DO - 10.4143/crt.2014.259
M3 - Article
AN - SCOPUS:84957608412
SN - 1598-2998
VL - 48
SP - 37
EP - 44
JO - Cancer Research and Treatment
JF - Cancer Research and Treatment
IS - 1
ER -