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Re-Irradiation for Recurrent Gliomas: Treatment Outcomes and Prognostic Factors.

 Jeongshim Lee  ;  Jaeho Cho  ;  Jong Hee Chang  ;  Chang-Ok Suh 
 YONSEI MEDICAL JOURNAL, Vol.57(4) : 824-830, 2016 
Journal Title
Issue Date
Adult ; Brain Neoplasms/mortality ; Brain Neoplasms/radiotherapy* ; Brain Neoplasms/surgery ; Female ; Glioma/mortality ; Glioma/radiotherapy* ; Glioma/surgery ; Humans ; Karnofsky Performance Status ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/radiotherapy* ; Neoplasm Recurrence, Local/surgery ; Re-Irradiation* ; Retrospective Studies ; Salvage Therapy ; Treatment Outcome ; Young Adult
Re-irradiation ; prognostic factor ; recurrent glioma ; survival
PURPOSE: The aim of this study was to evaluate the efficacy of re-irradiation in patients with recurrent gliomas and to identify subgroups for whom re-irradiation for recurrent gliomas is most beneficial. MATERIALS AND METHODS: We retrospectively reviewed 36 patients with recurrent or progressive gliomas who received re-irradiation between January 1996 and December 2011. Re-irradiation was offered to recurrent glioma patients with good performance or at least 6 months had passed after initial radiotherapy (RT), with few exceptions. RESULTS: Median doses of re-irradiation and initial RT were 45.0 Gy and 59.4 Gy, respectively. The median time interval between initial RT and re-irradiation was 30.5 months. Median overall survival (OS) and the 12-month OS rate were 11 months and 41.7%, respectively. In univariate analysis, Karnofsky performance status (KPS) ≥70 (p<0.001), re-irradiation dose ≥45 Gy (p=0.040), and longer time interval between initial RT and re-irradiation (p=0.040) were associated with improved OS. In multivariate analysis, KPS (p=0.030) and length of time interval between initial RT and re-irradiation (p=0.048) were important predictors of OS. A radiographically suspected mixture of radiation necrosis and progression after re-irradiation was seen in 5 patients. CONCLUSION: Re-irradiation in conjunction with surgery could be a salvage treatment for selected recurrent glioma patients with good performance status and recurrence over a long time.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Suh, Chang Ok(서창옥)
Lee, Jeong Shim(이정심)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
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