High-dose salvage re-irradiation in recurrent/progressive adult diffuse gliomas: development of a novel prognostic scoring system

Over the past two decades, high-dose salvage re-irradiation (re-RT) has been used increasingly in the multimodality management of adults with recurrent/progressive diffuse glioma. Several factors that determine outcomes following re-RT have been incorporated into prognostic models to guide patient s...

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Published in:Cancer radiothérapie 2022-11, Vol.26 (8), p.994-1001
Main Authors: Maitre, M., Gupta, T., Maitre, P., Chatterjee, A., Dasgupta, A., Moiyadi, A., Shetty, P., Epari, S., Sahay, A., Patil, V., Krishnatry, R., Sastri, G.J., Jalali, R.
Format: Article
Language:English
Subjects:
Diffuse glioma
Gliome diffus
Prognosis
Pronostic
Re-irradiation
Recurrence
Ré-irradiation
Récurrence
Survie
Survival
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Summary:Over the past two decades, high-dose salvage re-irradiation (re-RT) has been used increasingly in the multimodality management of adults with recurrent/progressive diffuse glioma. Several factors that determine outcomes following re-RT have been incorporated into prognostic models to guide patient selection. We aimed to develop a novel four-tiered prognostic model incorporating relevant molecular markers from our single-institutional cohort of patients treated with high-dose salvage re-RT for recurrent/progressive diffuse glioma. Various patient, disease, and treatment-related factors impacting upon survival following salvage re-RT were identified through univariate analysis. Each of these prognostic factors was further subdivided and assigned scores of 0 (low-risk), 1 (intermediate-risk), or 2 (high-risk). Scores from individual prognostic factors were added to derive the cumulative score (ranging from 0 to 16), with increasing scores indicating worsening prognosis. A total of 111 adults with recurrent/progressive diffuse glioma treated with salvage high-dose re-RT were included. We could assign patients into four prognostic subgroups (A=15 patients, score 0–3); (B=50 patients, score 4–7); (C=33 patients, score 8–10); and (D=13 patients, score 11–16) with completely non-overlapping survival curves suggesting the good discriminatory ability. Post-re-RT survival was significantly higher in Group A compared to groups B, C, and D, respectively (stratified log-rank p-value
ISSN:1278-3218
1769-6658
DOI:10.1016/j.canrad.2022.01.004