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Re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors

BACKGROUND: Despite the radical treatments applied, recurrence is encountered in the majority of high-grade gliomas (HGG). There is no standard treatment when recurrence is detected, but stereotactic radiotherapy (SRT) is a preferable alternative. The aim of this retrospective study is to evaluate t...

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Autores principales: Soykut, Ela Delikgoz, Odabasi, Eylem, Sahin, Nilgun, Tataroglu, Hatice, Baran, Ahmet, Guney, Yildiz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547398/
https://www.ncbi.nlm.nih.gov/pubmed/37795399
http://dx.doi.org/10.5603/RPOR.a2023.0034
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author Soykut, Ela Delikgoz
Odabasi, Eylem
Sahin, Nilgun
Tataroglu, Hatice
Baran, Ahmet
Guney, Yildiz
author_facet Soykut, Ela Delikgoz
Odabasi, Eylem
Sahin, Nilgun
Tataroglu, Hatice
Baran, Ahmet
Guney, Yildiz
author_sort Soykut, Ela Delikgoz
collection PubMed
description BACKGROUND: Despite the radical treatments applied, recurrence is encountered in the majority of high-grade gliomas (HGG). There is no standard treatment when recurrence is detected, but stereotactic radiotherapy (SRT) is a preferable alternative. The aim of this retrospective study is to evaluate the efficacy of SRT for recurrent HGG, and to investigate the factors that affect survival. MATERIALS AND METHODS: From 2013 to 2021, a total of 59 patients with 64 lesions were re-irradiated in a single center with the CyberKnife Robotic Radiosurgery System. The primary endpoints of the study were overall survival (OS), progression free survival (PFS) and local control rates (LCR). RESULTS: The median time to first recurrence was 13 (4–85) months. SRT was performed as a median prescription dose of 30 Gy (range 15–30), with a median of 5 fractions (1–5). The median follow-up time was 4 months (range 1–57). The median OS was 8 (95% CI: 4.66–11.33) months. Age, grade 3, tumor size were associated with better survival. The median PFS was 5 [95% confidence interval (CI): 3.39–6.60] months. Age, grade 3 and time to recurrence > 9 months were associated with improved PFS. Grade 3 gliomas (p = 0.027), size of tumor < 2 cm (p = 0.008) remained independent prognostic factors for OS in multivariate analysis. CONCLUSION: SRT is a viable treatment modality with significant survival contribution. Since it may have a favorable prognostic effect on survival in patients with tumor size < 2 cm, we recommend early diagnosis of recurrence and a decision to re-irradiate a smaller tumor during follow-up.
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spelling pubmed-105473982023-10-04 Re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors Soykut, Ela Delikgoz Odabasi, Eylem Sahin, Nilgun Tataroglu, Hatice Baran, Ahmet Guney, Yildiz Rep Pract Oncol Radiother Research Paper BACKGROUND: Despite the radical treatments applied, recurrence is encountered in the majority of high-grade gliomas (HGG). There is no standard treatment when recurrence is detected, but stereotactic radiotherapy (SRT) is a preferable alternative. The aim of this retrospective study is to evaluate the efficacy of SRT for recurrent HGG, and to investigate the factors that affect survival. MATERIALS AND METHODS: From 2013 to 2021, a total of 59 patients with 64 lesions were re-irradiated in a single center with the CyberKnife Robotic Radiosurgery System. The primary endpoints of the study were overall survival (OS), progression free survival (PFS) and local control rates (LCR). RESULTS: The median time to first recurrence was 13 (4–85) months. SRT was performed as a median prescription dose of 30 Gy (range 15–30), with a median of 5 fractions (1–5). The median follow-up time was 4 months (range 1–57). The median OS was 8 (95% CI: 4.66–11.33) months. Age, grade 3, tumor size were associated with better survival. The median PFS was 5 [95% confidence interval (CI): 3.39–6.60] months. Age, grade 3 and time to recurrence > 9 months were associated with improved PFS. Grade 3 gliomas (p = 0.027), size of tumor < 2 cm (p = 0.008) remained independent prognostic factors for OS in multivariate analysis. CONCLUSION: SRT is a viable treatment modality with significant survival contribution. Since it may have a favorable prognostic effect on survival in patients with tumor size < 2 cm, we recommend early diagnosis of recurrence and a decision to re-irradiate a smaller tumor during follow-up. Via Medica 2023-07-25 /pmc/articles/PMC10547398/ /pubmed/37795399 http://dx.doi.org/10.5603/RPOR.a2023.0034 Text en © 2023 Greater Poland Cancer Centre https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
spellingShingle Research Paper
Soykut, Ela Delikgoz
Odabasi, Eylem
Sahin, Nilgun
Tataroglu, Hatice
Baran, Ahmet
Guney, Yildiz
Re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors
title Re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors
title_full Re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors
title_fullStr Re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors
title_full_unstemmed Re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors
title_short Re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors
title_sort re-irradiation with stereotactic radiotherapy for recurrent high-grade glial tumors
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547398/
https://www.ncbi.nlm.nih.gov/pubmed/37795399
http://dx.doi.org/10.5603/RPOR.a2023.0034
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