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- Title
Radiosurgery and stereotactic brain radiotherapy with systemic therapy in recurrent high-grade gliomas: Is it feasible?
- Authors
Surgo, Alessia; Gregucci, Fabiana; Carbonara, Roberta; Laera, Letizia; Ciliberti, Maria Paola; Caliandro, Morena; Bonaparte, Ilaria; Fiorentino, Alba
- Abstract
Purpose: For recurrent high-grade gliomas (HGG) no standard therapeutic approach has been reported thus surgery, chemotherapy and reirradiation (re-RT) may all be proposed. The aim of the present study was to evaluate safety and efficacy of re-RT by radiosurgery or fractionated stereotactic radiotherapy (SRS/FSRT) in association to chemotherapy in patients with recurrent HGG. Material/methods: We included retrospectively all patients with histological diagnosis of HGG that, in the study period, suffered by recurrent disease diagnosed by magnetic resonance imaging (MRI), according to Response Assessment in Neuro-Oncology (RANO) criteria after primary/adjuvant chemo-radiotherapy treatment and underwent to re-RT by SRS/FSRT. Median dose was 24 Gy (range 18-36 Gy) and median number of fractions was 5 (range 1-6). Outcome was evaluated by clinical neurological examination and brain MRI performed 1 month after re-RT and then every 2-3 months. Results: From November 2019 to September 2021, 30 patients presenting recurrent HGG underwent re-RT. Median time between primary/adjuvant RT and disease recurrence was 8 months (range 2-27). In 6 cases (20%) reoperation was performed and, in most cases, (84%), a second line of systemic therapy was administrated. Median OS after recurrence was 12.1 months (95%CI 7.1-23.5). Six-month and 1-year OS were, respectively, 81% (95%CI 57-93%) and 51% (95%CI 26-72%). Median PFS after recurrence was 11.2 months (95%CI 6.2-23.1). Six-month and 1-year PFS were, respectively, 70% (95%CI 48-84%) and 32% (95%CI 13.12-52.8%). Regarding SRS/FSRT, no acute or late neurological side effects grade ≥ 2 were reported. No case of radionecrosis was detected. Conclusion: Re-RT with SRT/FSRT in association with second line systemic therapy is a safe and feasible treatment for patients with HGG recurrence. However, validation of these results by prospective studies is needed.
- Subjects
STEREOTACTIC radiosurgery; STEREOTACTIC radiotherapy; GLIOMAS; THERAPEUTICS; MAGNETIC resonance imaging; CHEMORADIOTHERAPY
- Publication
Journal of Radiosurgery & SBRT, 2022, Vol 8, p79
- ISSN
2156-4639
- Publication type
Article