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Re-Irradiation and Its Contribution to Good Prognosis in Recurrent Glioblastoma Patients

Brain Tumor Research and Treatment : BTRT 2020년 8권 1호 p.29 ~ 35
김미선, 임재준, 신현수, 조경기,
소속 상세정보
김미선 ( Kim Mi-Sun ) - CHA University CHA Bundang Medical Center Department of Radiation Oncology
임재준 ( Lim Jae-Joon ) - CHA University CHA Bundang Medical Center Department of Neurosurgery
신현수 ( Shin Hyun-Soo ) - CHA University CHA Bundang Medical Center Department of Radiation Oncology
조경기 ( Cho Kyung-Gi ) - CHA University CHA Bundang Medical Center Department of Neurosurgery

Abstract


Background: Radiation therapy, one of the strongest anti-cancer treatments, is already performed to treat primary glioblastoma; however, the effect of repeated radiation therapy for recurrent tumors has not been fully explored. The aim of this study was to determine the efficacy of re-irradiation in treating recurrent glioblastoma.

Methods: The study included 36 patients with recurrent glioblastoma treated with repeated radiation therapy between 2002 and 2016. Stereotactic radiosurgery (SRS) and hypo-fractionated stereotactic radiotherapy (HSRT) were performed in these patients.

Results: Fourteen patients received SRS with a median dose of 25 Gy (range, 20?32 Gy) in 1?5 fractions. Twenty-two patients received HSRT with a median dose of 40 Gy (range, 31.5?52 Gy) in 6?20 fractions. There were six treatment-related grade 3 adverse events. Survival analysis showed that re-irradiation significantly prolonged overall survival (OS) and progression-free survival (PFS). The median OS and one-year OS rate after re-irradiation were 17.2 months and 60.4%, respectively. The median PFS and 6-month PFS rate after re-irradiation were 4.4 months and 41.9%, respectively. Of the 36 patients, three survived without any progression in their condition.

Conclusion: Re-irradiation for recurrent glioblastoma showed favorable outcomes. Radiation dose and fractionation should be carefully considered to minimize radiation necrosis.

키워드

Recurrent glioblastoma; Re-irradiation; Stereotactic radiosurgery; Toxicity

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