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Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma

BACKGROUND: Patients with recurrent glioma after prior radiotherapy have a poor prognosis. Carbon ion beam radiotherapy offers highly conformal dose distributions and more complex biological radiation effects eventually resulting in optimized normal tissue sparing and improved outcome. The aim of th...

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Autores principales: Eberle, Fabian, Lautenschläger, Stefan, Engenhart-Cabillic, Rita, Jensen, Alexandra D, Carl, Barbara, Stein, Marco, Debus, Jürgen, Hauswald, Henrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995286/
https://www.ncbi.nlm.nih.gov/pubmed/32095084
http://dx.doi.org/10.2147/CMAR.S217824
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author Eberle, Fabian
Lautenschläger, Stefan
Engenhart-Cabillic, Rita
Jensen, Alexandra D
Carl, Barbara
Stein, Marco
Debus, Jürgen
Hauswald, Henrik
author_facet Eberle, Fabian
Lautenschläger, Stefan
Engenhart-Cabillic, Rita
Jensen, Alexandra D
Carl, Barbara
Stein, Marco
Debus, Jürgen
Hauswald, Henrik
author_sort Eberle, Fabian
collection PubMed
description BACKGROUND: Patients with recurrent glioma after prior radiotherapy have a poor prognosis. Carbon ion beam radiotherapy offers highly conformal dose distributions and more complex biological radiation effects eventually resulting in optimized normal tissue sparing and improved outcome. The aim of this study was to analyze toxicity, local control and overall survival after reirradiation of recurrent high-grade glioma with carbon ion radiotherapy. METHODS: Between 10/2015 and 12/2018, 30 patients (median age: 59 years) with recurrent high-grade glioma were reirradiated with carbon ion beams and retrospectively analyzed. Diagnosis of recurrent glioma was based on magnetic resonance imaging. Thirteen patients had repeated resection prior to reirradiation and 24 patients underwent additional chemotherapy. The median initial radiation dose was 60 Gy and the median time interval between the initial and repeated radiotherapy was 10 months. The reirradiation dose was 45 Gy (relative biological effectiveness) applied in 15 fractions. All patients received regular follow-up imaging after reirradiation. Kaplan-Meier estimation, log rank test and Cox regression analysis were used for statistical assessment. RESULTS: Applying common toxicity criteria, there were no grade 5 or 4 adverse events, while 8 patients showed grade 3 adverse events. The median follow-up after reirradiation was 11 months and the median overall survival after diagnosis of recurrent high-grade glioma was 13 months. The 6-, 12- and 24-month overall survival rates after diagnosis of recurrent high-grade glioma were 76%, 50% and 19%, respectively. Upon multivariate Cox regression analysis, a Ki67 score of the initial tumor histology of less than 20% was prognostic. Repeated resection or chemotherapy for the recurrent disease did not result in significantly prolonged survival. CONCLUSION: Carbon ion reirradiation in recurrent high-grade glioma is safe and feasible. No radiation-associated grade 4 toxicities were documented and treatment was tolerated well.
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spelling pubmed-69952862020-02-24 Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma Eberle, Fabian Lautenschläger, Stefan Engenhart-Cabillic, Rita Jensen, Alexandra D Carl, Barbara Stein, Marco Debus, Jürgen Hauswald, Henrik Cancer Manag Res Original Research BACKGROUND: Patients with recurrent glioma after prior radiotherapy have a poor prognosis. Carbon ion beam radiotherapy offers highly conformal dose distributions and more complex biological radiation effects eventually resulting in optimized normal tissue sparing and improved outcome. The aim of this study was to analyze toxicity, local control and overall survival after reirradiation of recurrent high-grade glioma with carbon ion radiotherapy. METHODS: Between 10/2015 and 12/2018, 30 patients (median age: 59 years) with recurrent high-grade glioma were reirradiated with carbon ion beams and retrospectively analyzed. Diagnosis of recurrent glioma was based on magnetic resonance imaging. Thirteen patients had repeated resection prior to reirradiation and 24 patients underwent additional chemotherapy. The median initial radiation dose was 60 Gy and the median time interval between the initial and repeated radiotherapy was 10 months. The reirradiation dose was 45 Gy (relative biological effectiveness) applied in 15 fractions. All patients received regular follow-up imaging after reirradiation. Kaplan-Meier estimation, log rank test and Cox regression analysis were used for statistical assessment. RESULTS: Applying common toxicity criteria, there were no grade 5 or 4 adverse events, while 8 patients showed grade 3 adverse events. The median follow-up after reirradiation was 11 months and the median overall survival after diagnosis of recurrent high-grade glioma was 13 months. The 6-, 12- and 24-month overall survival rates after diagnosis of recurrent high-grade glioma were 76%, 50% and 19%, respectively. Upon multivariate Cox regression analysis, a Ki67 score of the initial tumor histology of less than 20% was prognostic. Repeated resection or chemotherapy for the recurrent disease did not result in significantly prolonged survival. CONCLUSION: Carbon ion reirradiation in recurrent high-grade glioma is safe and feasible. No radiation-associated grade 4 toxicities were documented and treatment was tolerated well. Dove 2020-01-28 /pmc/articles/PMC6995286/ /pubmed/32095084 http://dx.doi.org/10.2147/CMAR.S217824 Text en © 2020 Eberle et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Eberle, Fabian
Lautenschläger, Stefan
Engenhart-Cabillic, Rita
Jensen, Alexandra D
Carl, Barbara
Stein, Marco
Debus, Jürgen
Hauswald, Henrik
Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma
title Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma
title_full Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma
title_fullStr Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma
title_full_unstemmed Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma
title_short Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma
title_sort carbon ion beam reirradiation in recurrent high-grade glioma
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995286/
https://www.ncbi.nlm.nih.gov/pubmed/32095084
http://dx.doi.org/10.2147/CMAR.S217824
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