We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Re-irradiation for recurrent glioma: outcome evaluation, toxicity and prognostic factors assessment. A multicenter study of the Radiation Oncology Italian Association (AIRO).
- Authors
Navarria, Pierina; Minniti, Giuseppe; Clerici, Elena; Tomatis, Stefano; Pinzi, Valentina; Ciammella, Patrizia; Galaverni, Marco; Amelio, Dante; Scartoni, Daniele; Scoccianti, Silvia; Krengli, Marco; Masini, Laura; Draghini, Lorena; Maranzano, Ernesto; Borzillo, Valentina; Muto, Paolo; Ferrarese, Fabio; Fariselli, Laura; Livi, Lorenzo; Pasqualetti, Francesco
- Abstract
Introduction: The prognosis of glioma is dismal, and almost all patients relapsed. At recurrence time, several treatment options are considered, but to date there is no a standard of care. The Neurooncology Study Group of the Italian Association of Radiation Oncology (AIRO) collected clinical data regarding a large series of recurrent glioma patients who underwent re-irradiation (re-RT) in Italy.Methods: Data regarding 300 recurrent glioma patients treated from May 2002 to November 2017, were analyzed. All patients underwent re-RT. Surgical resection, followed by re-RT with concomitant and adjuvant chemotherapy was performed. Clinical outcome was evaluated by neurological examination and brain MRI performed, 1 month after radiation therapy and then every 3 months.Results: Re-irradiation was performed at a median interval time (IT) of 16 months from the first RT. Surgical resection before re-RT was performed in 19% of patients, concomitant temozolomide (TMZ) in 16.3%, and maintenance chemotherapy in 29%. Total doses ranged from 9 Gy to 52.5 Gy, with a median biological effective dose of 43 Gy. The median, 1, 2 year OS were 9.7 months, 41% and 17.7%. Low grade glioma histology (p ≪ 0.01), IT > 12 months (p = 0.001), KPS > 70 (p = 0.004), younger age (p = 0.001), high total doses delivered (p = 0.04), and combined treatment performed (p = 0.0008) were recorded as conditioning survival.Conclusion: our data underline re-RT as a safe and feasible treatment with limited rate of toxicity, and a combined ones as a better option for selected patients. The identification of a BED threshold able to obtain a greater benefit on OS, can help in designing future prospective studies.
- Subjects
ITALY; RADIOTHERAPY; ADJUVANT treatment of cancer; TEMOZOLOMIDE; ONCOLOGY; LONGITUDINAL method; RADIATION
- Publication
Journal of Neuro-Oncology, 2019, Vol 142, Issue 1, p59
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-018-03059-x