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Re-irradiation of recurrent glioblastoma as part of a sequential multimodality treatment concept

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Abstract

Purpose

The aim of this retrospective study was to evaluate survival outcomes in well-performing, mainly, young patients receiving a sequence of all available therapeutic options for relapsed glioblastoma, including re-irradiation.

Methods

We performed a retrospective analysis of 27 patients irradiated twice for glioblastoma between 2008 and 2016. In the first line, all had surgical treatment of the tumor followed by radiotherapy with a total dose of 60 Gy and temozolomide. All re-irradiated patients were treated with a total dose of 36 Gy in 12 fractions. The endpoints were death from glioblastoma or any cause, and toxicity after re-irradiation.

Results

The median follow-up of survivors was 35.6 months. At the time of analysis, 25 patients had died. The median time between first and second radiotherapy was 18.9 months (6.1–58.4). Re-irradiation was performed at different time points of first, second and third progression. The median overall survival after first diagnosis was 39.2 months. Five years after first surgery, nearly 20% of the patients were alive.

Conclusion

Carefully planned re-irradiation of the brain is a safe therapy for recurrent glioblastoma. Younger and well-performing patients benefit from all available therapy options. Every patient should be discussed in a multidisciplinary setting at each time point of tumor progression. Further prospective studies are needed to define the optimal time, dose and volume of re-irradiation.

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Authors and Affiliations

  1. Department of Radiation Oncology, Ordensklinikum Barmherzige Schwestern Linz, Seilerstätte 4, 4010, Linz, Austria

    E. Bräutigam, C. Track, J. Hammer & H. Geinitz

  2. Department of Geriatric Medicine, Ordensklinikum Barmherzige Schwestern Linz, Linz, Austria

    C. Lampl

  3. Department of Oncology and Palliative Medicine, Nordland Hospital Trust, 8092, Bodø, Norway

    C. Nieder

  4. Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9037, Tromsø, Norway

    C. Nieder

  5. Neurooncology, Neuromedcampus Linz, Linz, Austria

    J. Pichler

Authors
  1. E. Bräutigam
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  2. C. Lampl
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  3. C. Track
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  4. C. Nieder
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  5. J. Pichler
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  6. J. Hammer
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  7. H. Geinitz
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Corresponding author

Correspondence to E. Bräutigam.

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Conflict of interest

All authors declared no conflicts of interest.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by the authors. Treatment and follow-up were performed according to the accepted standards of good clinical practice in agreement with the latest version of the Declaration of Helsinki.

Informed consent

All patients provided written informed consent before being included in the retrospective study.

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Bräutigam, E., Lampl, C., Track, C. et al. Re-irradiation of recurrent glioblastoma as part of a sequential multimodality treatment concept. Clin Transl Oncol 21, 582–587 (2019). https://doi.org/10.1007/s12094-018-1957-6

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  • DOI: https://doi.org/10.1007/s12094-018-1957-6

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