Zweitbestrahlung bei malignen Gliomen: eine retrospektive Auswertung

Abstract

Re-irradiation in malignant glioma is a feasible and safe treatment option, and the benefit appears to be especially large in re-resected patients. To make a final conclusion possible, larger prospective trials are warranted.

Hypofractionated reirradiation for recurrent malignant glioma

“…Two groups report on an overall survival of 8-10 months with a total dose of 30 Gy using a hypofractionated schedule with a single dose of 5 Gy [42,43]. An association of longer overall survival times with prior reresection as described before [4] was not seen in our series.…”

“…Comparison of overall survival and toxicity of the chosen treatment with results of different approaches using external-beam radiotherapy for reirradiation reported over the last years [1,4,8,9,11,22,25,35,36,[41][42][43] certainly remains difficult because of the variation in target definition, treatment technique, tumor volume, concomitant chemotherapy, and initial patient characteristics. However, considering the large median PTV of 50 ml and the high number of glioblastoma included, this is comparable to the earlier results.…”

“…In this regard, several different modalities of percutaneous radiotherapy or brachytherapy for retreatment of glioblastomas have been investigated. In general, all data consistently show that, whenever employed cautiously, reirradiation is feasible and most likely prolongs survival [1,4,7,8,11,13,14,21,24,34,35,38,[40][41][42].…”

Multiple Microsurgical Resections for Repeated Recurrence of Glioblastoma Multiforme

“…[35][36][37] Data on the effect of reirradiation, applied as normofractionated or hypofractionated stereotactic small volume radiotherapy are limited regarding further tumor growth, but it may aggravate neurological toxicity. [38][39][40][41][42][43][44][45][46][47] In long-term survivors, there are concerns regarding radiation-induced late sequelae, in particular delayed leukoencephalopathy with neurocognitive dysfunction or radiation necrosis. [48][49][50] It was shown that chemotherapy after surgery for the initial tumor is significantly correlated with time to tumor progression and survival, but the role of chemotherapy in recurrence has not been fully elucidated, and chemotherapy can be problematic with regard to the biological status of the tumor and the increased risk of cumulative toxicity.…”

Neurophysiological status and adaptation responses upon application of electromagnetic fields in complex treatment of patients with malignant gliomas of the brain

“…By estimating the primary tumors of the brain in the adult population in Russia, statistics data show that gliomas of the brain accounts for 40-46 % of the cases, with 55 % of malignant tumors among them. Considering the glial tumors, the largest proportion is made by glioblastomas (16,7 %) as well as by astrocytic tumors (17,9 %), and in this case the malignant types of astrocytomas tend to occur 1,3 times more frequent ly in male individuals and 2 times more frequently in females as compared to the benign neoplasms [1,2].…”