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A second course of radiotherapy in patients with recurrent malignant gliomas: Clinical data on re-irradiation, prognostic factors, and usefulness of digital biomarkers.
Curr. Treat. Options Oncol. 20:71 (2019)
The treatment of malignant gliomas has undergone a significant intensification during the past decade, and the interdisciplinary treatment team has learned that all treatment opportunities, including surgery and radiotherapy (RT), also have a central role in recurrent gliomas. Throughout the decades, re-irradiation (re-RT) has achieved a prominent place in the treatment of recurrent gliomas. A solid body of evidence supports the safety and efficacy of re-RT, especially when modern techniques are used, and justifies the early use of this regimen, especially in the case when macroscopic disease is present. Additionally, a second adjuvant re-RT to the resection cavity is currently being investigated by several investigators and seems to offer promising results. Although advanced RT technologies, such as stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy (FSRT), intensity-modulated radiotherapy (IMRT), and image-guided radiotherapy (IGRT) have become available in many centers, re-RT should continue to be kept in experienced hands so that they can select the optimal regimen, the ideal treatment volume, and the appropriate techniques from their tool-boxes. Concomitant or adjuvant use of systemic treatment options should also strongly be taken into consideration, especially because temozolomide (TMZ), cyclohexyl-nitroso-urea (CCNU), and bevacizumab have shown a good safety profile; they should be considered, if available. Nonetheless, the selection of patients for re-RT remains crucial. Single factors, such as patient age or the progression-free interval (PFI), fall too short. Therefore, powerful prognostic scores have been generated and validated, and these scores should be used for patient selection and counseling.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Review
Schlagwörter
Glioblastoma ; Re-irradiation ; Radiotherapy ; Recurrent Glioblastoma ; Treatment ; Patient Selection; High-grade Glioma; Amino-acid Pet; Glioblastoma-multiforme; Stereotactic Radiosurgery; Complete Resection; Tumor Volume; Phase-ii; Survival; Temozolomide; Multicenter
ISSN (print) / ISBN
1527-2729
e-ISSN
1534-6277
Zeitschrift
Current Treatment Options in Oncology
Quellenangaben
Band: 20,
Heft: 9,
Artikelnummer: 71
Verlag
Springer
Verlagsort
233 Spring St, New York, Ny 10013 Usa
Nichtpatentliteratur
Publikationen
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Radiation Medicine (IRM)