Patterns of re-irradiation for recurrent gliomas and validation of a prognostic score

•Median OS of patients eligible for ReRT is 9.7 months in our series.•Registered toxicity rates are low (severe acute toxicity 13% and radionecrosis 8%).•The reirradiation risk score of Niyazi et al. was successfully validated.•Collaboration among medical centers is necessary to achieve optimized tr...

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Bibliographic Details
Published in:Radiotherapy and oncology 2019-01, Vol.130, p.156-163
Main Authors: Post, Cathalijne C.B., Kramer, Miranda C.A., Smid, Ernst J., van der Weide, Hiske L., Kleynen, Catharina E., Heesters, Mart A.A.M., Verhoeff, Joost J.C.
Format: Article
Language:English
Subjects:
Adult
Aged
Brain Neoplasms - mortality
Brain Neoplasms - pathology
Brain Neoplasms - radiotherapy
Dose Fractionation, Radiation
Female
Glioma
Glioma - mortality
Glioma - pathology
Glioma - radiotherapy
Humans
Male
Middle Aged
Neoplasm recurrence, local
Neoplasm Recurrence, Local - radiotherapy
Radiosurgery
Radiotherapy dosage
Re-Irradiation
Recurrence
Retrospective Studies
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Summary:•Median OS of patients eligible for ReRT is 9.7 months in our series.•Registered toxicity rates are low (severe acute toxicity 13% and radionecrosis 8%).•The reirradiation risk score of Niyazi et al. was successfully validated.•Collaboration among medical centers is necessary to achieve optimized treatment regimen. Re-irradiation is a generally accepted method for salvage treatment in patients with recurrent glioma. However, no standard radiation regimen has been defined. This study aims to compare the efficacy and safety of different treatment regimens and to independently externally validate a recently published reirradiation risk score. We retrospectively analyzed a cohort of patients with recurrent malignant glioma treated with salvage conventionally fractionated (CFRT), hypofractionated (HFRT) or stereotactic radiotherapy (SRT) between 2007 and 2017 at the University Medical Centers in Utrecht and Groningen. Of the 121 patients included, 60 patients (50%) underwent CFRT, 22 (18%) HFRT and 39 (32%) SRT. The primary tumor was grade II-III in 52 patients and grade IV in 69 patients with median Overall Survival (mOS) since first surgery of 113 [Interquartile range: 53.2–137] and 39.7 [24.6–64.9] months respectively (p 
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2018.10.034