Reirradiation for recurrent glioma. (31st January 2018)

• Record Type: Journal Article
• Authors: Williamson, Aoife; Mackinnon, Mairi; James, Allan; Chalmers, Anthony; Nowicki, Stefan
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 1
• Page Start: i11
• Page End: i12
• Publication Date: 2018-01-31
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/nox238.049
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: 14 patients who received re-irradiation for recurrent glioma were identified. GTV was defined as the contrast-enhancing lesion on T1 MRI. No CTV was defined. Median GTV- PTV margin was 1.25cm. All patients received VMAT, 2 non co-planar arcs. The dose was 30Gy in 5 fractions. A cohort of 22 recurrent glioma patients was also identified. This group did not receive reirradiation. Reirrradiation cohort: Median age was 49. 5 patients had GBM, 2 had astrocytoma and 7 had oligodendroglioma. All LGG patients had radiological evidence of transformation to higher grade. At time of re-irradiation, patients had a mean KPS of 70% and had progressed through at least one line of chemo. 1 week post XRT median KPS was 70%. 1 month post XRT median KPS was 90%. Median dexamethasone dose was 2mg pre-XRT, 4mg 1 week post XRT and 4 mg 1 month post XRT. No severe acute or late complications were observed. PFS from irradiation was 4.2 months for GBM, 6.1 months for LGG. Median survival from reirradiation was 8 months for GBM and 11 months for LGG. Median OS from diagnosis for GBM was 34 months, and 126 months for LGG. A similar cohort of patients aged <65, KPS >70% who had progressed through at least one line of chemo after primary xrt were identified. 12 were GBM patients: median survival from 2nd line treatment was 11 months, median OS was 31 months. 10 LGG patients were identified with a median survival from 2nd line treatment of 12 months and median OS was 61.5 months. Conclusion Re-irradiation is a safe and feasible treatment. The majority of patients experienced an improvement in PS after treatment. However in this small, retrospective study there was no signal that reirradiation was associated with improved survival when compared with similar cohorts managed without reirradiation.