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. 2018 Jan 1:17:1533033818806498.
doi: 10.1177/1533033818806498.

Hypofractionated Stereotactic Radiotherapy as a Salvage Therapy for Recurrent High-Grade Gliomas: Single-Center Experience

Thomas Reynaud  1 , Aurélie Bertaut  2 , Walid Farah  3 , David Thibouw  1 , Gilles Crehange  1 , Gilles Truc  1 , Noémie Vulquin  1
Affiliations

Hypofractionated Stereotactic Radiotherapy as a Salvage Therapy for Recurrent High-Grade Gliomas: Single-Center Experience

Thomas Reynaud et al. Technol Cancer Res Treat. .

Abstract

Background and purpose: The aim of this study was to investigate the survival outcomes and safety of hypofractioned stereotactic radiotherapy as a salvage treatment for recurrent high-grade glioma.

Patients and methods: Between March 2012 and March 2017, 32 consecutive patients (12 women, 20 men) treated in a single center were retrospectively included in this study. Grade III gliomas were diagnosed in 14 patients and grade IV in 18 patients. Thirty-four lesions were treated with hypofractionated stereotactic radiotherapy on a linear accelerator. Hypofractionated stereotactic radiotherapy delivered a median dose of 30 Gy (27-30) in 6 fractions (3-6) of 5 Gy (5-9). The treatment plans were normalized to 100% at the isocenter and prescribed to the 80% isodose line. Clinical outcomes and prognostic factors were analyzed.

Results: Median follow-up was 20.9 months. Median overall survival following hypofractionated stereotactic radiotherapy was 15.6 months (median overall survival for patients with glioblastoma and grade III glioma was 8.2 and 19.5 months, respectively; P = .0496) and progression-free survival was 3.7 months (median progression-free survival for patients with glioblastoma and grade III glioma was 3.6 and 4.5 months, respectively; P = .2424). In multivariate analysis, tumor grade III ( P = .0027), an Eastern Cooperative Oncology Group status <2 at the time of reirradiation ( P = .0023), and a mean dose >35 Gy ( P = .0055) significantly improved overall survival. A maximum reirradiation dose above 38 Gy ( P = .0179) was significantly associated with longer progression-free survival.

Conclusion: Hypofractionated stereotactic radiotherapy is well tolerated and offers an effective salvage option for the treatment of recurrent high-grade gliomas with encouraging overall survival. Our results suggest that the dose distribution had an impact on survival.

Keywords: high-grade glioma; hypofractionated; recurrence; salvage; stereotactic radiotherapy.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Kaplan-Meier OS after HFSRT for patients with GBM and grade III glioma. OS indicates overall survival; HFSRT, hypofractionated stereotactic radiotherapy; GBM, glioblastoma.
Figure 2.
Figure 2.
Kaplan-Meier PFS after HFSRT for patients with GBM and grade III glioma. PFS indicates progression-free survival; HFSRT, hypofractionated stereotactic radiotherapy; GBM, glioblastoma.
See this image and copyright information in PMC

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