Low Fraction Size Re-irradiation for Large Volume Recurrence of Glial Tumours
- PDF / 526,170 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 56 Downloads / 158 Views
ORIGINAL ARTICLE
Low Fraction Size Re-irradiation for Large Volume Recurrence of Glial Tumours Ágnes Dobi 1 & Barbara Darázs 1 & Emese Fodor 1 & Adrienne Cserháti 1 & Zsófia Együd 1 & Anikó Maráz 1 & Szilvia László 1 & Leopold Dodd 1 & Zita Reisz 2 & Pál Barzó 3 & Judit Oláh 1 & Katalin Hideghéty 1 Received: 29 April 2020 / Accepted: 30 June 2020 # The Author(s) 2020
Abstract The aim of the present study was to evaluate the efficacy of re-irradiation (re-RT) in patients with advanced local relapses of glial tumours and to define the factors influencing the result of the hyper-fractionated external beam therapy on progression after primary management. We have analysed the data of 55 patients with brain tumours (GBM: 28) on progression, who were reirradiated between January 2007 and December 2018. The mean volume of the recurrent tumour was 118 cm3, and the mean planning target volume (PTV) was 316 cm3, to which 32 Gy was delivered in 20 fractions at least 7.7 months after the first radiotherapy, using 3D conformal radiotherapy (CRT) or intensity modulated radiotherapy (IMRT). The median overall survival (mOS) from the re-RT was 8.4 months, and the 6-month and the 12-month OS rate was 64% and 31%, respectively. The most important factors by univariate analysis, which significantly improved the outcome of re-RT were the longer time interval between the diagnosis and second radiotherapy (p = 0.029), the lower histology grade (p = 0.034), volume of the recurrent tumour (p = 0.006) and Karnofsky performance status (KPS) (p = 0.009) at the re-irradiation. Our low fraction size re-irradiation ≥ 8 months after the first radiotherapy proved to be safe and beneficial for patients with large volume recurrent glial tumours. Keywords Re-irradiation . Multiform glioblastoma . Glioma
1. Introduction Gliomas, with incidence of 5/100 000 in adults, are the most common primary central nervous system malignancies, peaking between the fifth and sixth decades of life [1]. After initial multimodal treatment, at least 70% recurrence rate of gliomas can be expected [2–4]. By surgical therapy alone, the disease has a very poor prognosis (median survival 4–6 months [5], whereas surgery accompanied by radiotherapy (RT) ameliorates the median survival data to 8–9 months. Together with concomitant and sequential TMZ, better median survival values can be expected,
* Ágnes Dobi [email protected] 1
Department of Oncotherapy, University of Szeged, Korányi fasor 12, Szeged H-6720, Hungary
2
Department of Pathology, University of Szeged, Állomás utca 1, Szeged H-6725, Hungary
3
Department of Neurosurgery, University of Szeged, Semmelweis utca 6, Szeged H-6725, Hungary
such as 15 months for glioblastomas, or even 2–5 years for anaplastic gliomas [6]. In the case of recurrence with its considerable limitations, and only if it is possible, surgical treatment has the highest efficacy [7]. In certain good performance status patients with good anatomical access to tumours, surgery is applicable, but the resection outcome could be definitely lim
Data Loading...
