ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2017
Re-irradiation after gross total resection of recurrent glioblastoma : Spatial pattern of recurrence and a review of the literature as a basis for target volume definition.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Spatial patterns of progression in reported glioblastoma cohorts after upfront chemoradiation and salvage therapy: a systematic review and meta-analysis.Journal of neuro-oncology · 2026Pooled it
- Congress of Neurological Surgeons systematic review and evidence-based guidelines update on the role of radiation therapy in the management of progressive and recurrent glioblastoma in adults.Journal of neuro-oncology · 2022Pooled it
- Neuroimaging classification of progression patterns in glioblastoma: a systematic review.Journal of neuro-oncology · 2018Pooled it
- Safety and patterns of survivorship in recurrent GBM following resection and surgically targeted radiation therapy: Results from a prospective trial.Neuro-oncology · 2022Trial
- Radiomics in glioblastoma recurrence: advances in prediction, localization, and differentiation from treatment-related effects.Journal of translational medicine · 2026Review
- Preferred Imaging for Target Volume Delineation for Radiotherapy of Recurrent Glioblastoma: A Literature Review of the Available Evidence.Journal of personalized medicine · 2024Review
- Adjuvant re-irradiation vs. no early re-irradiation of resected recurrent glioblastoma: pooled comparative cohort analysis from two tertiary centers.Journal of neuro-oncology · 2024Article
- Hypofractionated stereotactic re-irradiation for progressive glioblastoma: twelve years' experience of a single center.Journal of neuro-oncology · 2024Article
- Review
- Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era.Biomedicines · 2022Review
- Comparison of carbon ion and photon reirradiation for recurrent glioblastoma.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022Article
- Bevacizumab combined with re-irradiation in recurrent glioblastoma.Frontiers in oncology · 2022Article
- Re-irradiation for high-grade gliomas: Has anything changed?World journal of clinical oncology · 2021Review
- Low Fraction Size Re-irradiation for Large Volume Recurrence of Glial Tumours.Pathology oncology research : POR · 2020Article
- Radiomics in radiation oncology-basics, methods, and limitations.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2020Review
- Spatial distribution of malignant transformation in patients with low-grade glioma.Journal of neuro-oncology · 2020Article
- On PTV definition for glioblastoma based on fiber tracking of diffusion tensor imaging data.PloS one · 2020Article
- A Second Course of Radiotherapy in Patients with Recurrent Malignant Gliomas: Clinical Data on Re-irradiation, Prognostic Factors, and Usefulness of Digital Biomarkers.Current treatment options in oncology · 2019Review
- Re-irradiation in elderly patients with glioblastoma: a single institution experience.Journal of neuro-oncology · 2019Article
- Appraisal of re-irradiation for the recurrent glioblastoma in the era of MGMT promotor methylation.Radiation oncology journal · 2019Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrently, patients with gross total resection (GTR) of recurrent glioblastoma (rGBM) undergo adjuvant chemotherapy or are followed up until progression. Re-irradiation, as one of the most effective treatments in macroscopic rGBM, is withheld in this situation, as uncertainties about the pattern of re-recurrence, the target volume, and also the efficacy of early re-irradiation after GTR exist.
methodsImaging and clinical data from 26 consecutive patients with GTR of rGBM were analyzed. The spatial pattern of recurrences was analyzed according to the RANO-HGG criteria ("response assessment in neuro-oncology criteria for high-grade gliomas"). Progression-free (PFS) and overall survival (OS) were analyzed by the Kaplan-Meier method. Furthermore, a systematic review was performed in PubMed.
resultsAll but 4 patients underwent adjuvant chemotherapy after GTR. Progression was diagnosed in 20 of 26 patients and 70% of recurrent tumors occurred adjacent to the resection cavity. The median extension beyond the edge of the resection cavity was 20 mm. Median PFS was 6 months; OS was 12.8 months. We propose a target volume containing the resection cavity and every contrast enhancing lesion as the gross tumor volume (GTV), a spherical margin of 5-10 mm to generate the clinical target volume (CTV), and a margin of 1-3 mm to generate the planning target volume (PTV). Re-irradiation of this volume is deemed to be safe and likely to prolong PFS.
conclusionRe-irradiation is worth considering also after GTR, as the volumes that need to be treated are limited and re-irradiation has already proven to be a safe treatment option in general. The strategy of early re-irradiation is currently being tested within the GlioCave/NOA 17/Aro 2016/03 trial.
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