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Safety and efficacy of Hypofractionated stereotactic radiosurgery for high-grade Gliomas at first recurrence: a single-center experience.

Authors :
Guan, Yun
Xiong, Ji
Pan, Mingyuan
Shi, Wenyin
Li, Jing
Zhu, Huaguang
Gong, Xiu
Li, Chao
Mei, Guanghai
Liu, Xiaoxia
Pan, Li
Dai, Jiazhong
Wang, Yang
Wang, Enmin
Wang, Xin
Source :
BMC Cancer. 2/5/2021, Vol. 21 Issue 1, p1-8. 8p.
Publication Year :
2021

Abstract

<bold>Background: </bold>The optimal treatment for recurrent high-grade gliomas (rHGGs) remains uncertain. This study aimed to investigate the efficacy and safety of hypofractionated stereotactic radiosurgery (HSRS) as a first-line salvage treatment for in-field recurrence of high-grade gliomas.<bold>Methods: </bold>Between January 2016 and October 2019, 70 patients with rHGG who underwent HSRS were retrospectively analysed. The primary endpoint was overall survival (OS), and secondary endpoints included both progression-free survival (PFS) and adverse events, which were assessed according to Common Toxicity Criteria Adverse Events (CTCAE) version 5. The prognostic value of key clinical features (age, performance status, planning target volume, dose, use of bevacizumab) was evaluated.<bold>Results: </bold>A total of 70 patients were included in the study. Forty patients were male and 30 were female. Forty-nine had an initial diagnosis of glioblastoma (GBM), and the rest (21) were confirmed to be WHO grade 3 gliomas. The median planning target volume (PTV) was 16.68 cm3 (0.81-121.96 cm3). The median prescribed dose was 24 Gy (12-30 Gy) in 4 fractions (2-6 fractions). The median baseline of Karnofsky Performance Status (KPS) was 70 (40-90). With a median follow-up of 12.1 months, the median overall survival after salvage treatment was 17.6 months (19.5 and 14.6 months for grade 3 and 4 gliomas, respectively; p = .039). No grade 3 or higher toxicities was recorded. Multivariate analysis showed that concurrent bevacizumab with radiosurgery and KPS > 70 were favourable prognostic factors for grade 4 patients with HGG.<bold>Conclusions: </bold>Salvage HSRS showed a favourable outcome and acceptable toxicity for rHGG. A prospective phase II study (NCT04197492) is ongoing to further investigate the value of hypofractionated stereotactic radiosurgery (HSRS) in rHGG. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14712407
Volume :
21
Issue :
1
Database :
Academic Search Index
Journal :
BMC Cancer
Publication Type :
Academic Journal
Accession number :
148519002
Full Text :
https://doi.org/10.1186/s12885-021-07856-y