ArticleRadiation oncology (London, England)2017
Re-irradiation for recurrent glioma- the NCI experience in tumor control, OAR toxicity and proposal of a novel prognostic scoring system.
Article in Radiation oncology (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Proton Bragg peak flash stereotactic radiosurgery for recurrent glioblastoma reirradiation.Physics and imaging in radiation oncology · 2026Article
- Efficacy and safety of combining re-irradiation with bevacizumab compared to bevacizumab alone in the management of recurrent high-grade gliomas: a meta-analysis and systematic review.Therapeutic advances in neurological disorders · 2025Article
- The evolving role of reirradiation in the management of recurrent brain tumors.Journal of neuro-oncology · 2023Review
- How ten-years of reirradiation for paediatric high-grade glioma may shed light on first line treatment.Journal of neuro-oncology · 2022Article
- Bevacizumab is an effective treatment for symptomatic cerebral necrosis after carbon ion therapy for recurrent intracranial malignant tumours: A case report.Molecular and clinical oncology · 2022Article
- Optimising tumour coverage and organ at risk sparing for hypofractionated re-irradiation in glioblastoma.Physics and imaging in radiation oncology · 2022Article
- High-dose salvage re-irradiation for recurrent/progressive adult diffuse glioma: healing or hurting?Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021Article
- Current status and recent advances in reirradiation of glioblastoma.Radiation oncology (London, England) · 2021Review
- Re-irradiation of recurrent glioblastoma using helical TomoTherapy with simultaneous integrated boost: preliminary considerations of treatment efficacy.Scientific reports · 2020Article
- Low Fraction Size Re-irradiation for Large Volume Recurrence of Glial Tumours.Pathology oncology research : POR · 2020Article
- Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma.Cancer management and research · 2020Article
- Appraisal of re-irradiation for the recurrent glioblastoma in the era of MGMT promotor methylation.Radiation oncology journal · 2019Article
- A Phase 1 Dose-Escalation Trial of Reirradiation for Patients With Recurrent Glioblastoma.Practical radiation oncologyArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
PURPOSE/
objectivesDespite mounting evidence for the use of re-irradiation (re-RT) in recurrent high grade glioma, optimal patient selection criteria for re-RT remain unknown. We present a novel scoring system based on radiobiology principles including target independent factors, the likelihood of target control, and the anticipated organ at risk (OAR) toxicity to allow for proper patient selection in the setting of recurrent glioma. MATERIALS/
methodsThirty one patients with recurrent glioma who received re-RT (2008-2016) at NCI - NIH were included in the analysis. A novel scoring system for overall survival (OS) and progression free survival (PFS) was designed to include:1) target independent factors (age, KPS (Karnofsky Performance Status), histology, presence of symptoms), 2) target control, and 3) OAR toxicity risk. Normal tissue complication probability (NTCP) calculations were performed using the Lyman model. Kaplan-Meier analysis was performed for overall survival (OS) and progression free survival (PFS) for comparison amongst variables.
resultsNo patient, including those who received dose to OAR above the published tolerance dose, experienced any treatment related grade 3-5 toxicity with a median PFS and OS from re-RT of 4 months (0.5-103) and 6 months (0.7-103) respectively. Based on cumulative maximum doses the average NTCP was 25% (0-99%) for the chiasm, 21% (0-99%) for the right optic nerve, 6% (0-92%) for the left optic nerve, and 59% (0-100%) for the brainstem. The independent factor and target control scores were each statistically significant for OS and the combination of independent factors plus target control was also significant for both OS (p = 0.02) and PFS (p = 0.006). The anticipated toxicity risk score was not statistically significant.
conclusionOur scoring system may represent a novel approach to patient selection for re-RT in recurrent high grade glioma. Further validation in larger patient cohorts including compilation of doses to tumor and OAR may help refine this further for inclusion into clinical trials and general practice.
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