Despite aggressive management consisting of maximal safe surgical resection followed by external beam radiation therapy (60 Gy/30 fractions) with concomitant and adjuvant temozolomide, approximately 90% of WHO grade IV gliomas (glioblastomas, GBM) will recur locally within 2 years. For patients with recurrent GBM, no standard of care exists. Thanks to the continuous improvement in radiation science and technology, reirradiation has emerged as feasible approach for patients with brain tumors. Using stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT), either hypofractionated or conventionally fractionated schedules, several studies have suggested survival benefits following reirradiation of patients with recurrent GBM; however, there are still questions to be answered about the efficacy and toxicity associated with a second course of radiation. We provide a clinical overview on current status and recent advances in reirradiation of GBM, addressing relevant clinical questions such as the appropriate patient selection and radiation technique, optimal dose fractionation, reirradiation tolerance of the brain and the risk of radiation necrosis.

Current status and recent advances in reirradiation of glioblastoma / Minniti, G.; Niyazi, M.; Alongi, F.; Navarria, P.; Belka, C.. - In: RADIATION ONCOLOGY. - ISSN 1748-717X. - 16:1(2021). [10.1186/s13014-021-01767-9]

Current status and recent advances in reirradiation of glioblastoma

Minniti G.
Primo
;
2021

Abstract

Despite aggressive management consisting of maximal safe surgical resection followed by external beam radiation therapy (60 Gy/30 fractions) with concomitant and adjuvant temozolomide, approximately 90% of WHO grade IV gliomas (glioblastomas, GBM) will recur locally within 2 years. For patients with recurrent GBM, no standard of care exists. Thanks to the continuous improvement in radiation science and technology, reirradiation has emerged as feasible approach for patients with brain tumors. Using stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT), either hypofractionated or conventionally fractionated schedules, several studies have suggested survival benefits following reirradiation of patients with recurrent GBM; however, there are still questions to be answered about the efficacy and toxicity associated with a second course of radiation. We provide a clinical overview on current status and recent advances in reirradiation of GBM, addressing relevant clinical questions such as the appropriate patient selection and radiation technique, optimal dose fractionation, reirradiation tolerance of the brain and the risk of radiation necrosis.
2021
hypofractionated radiotherapy; radionecrosis; recurrent glioblastoma; reirradiation; stereotactic radiosurgery; target delineation
01 Pubblicazione su rivista::01a Articolo in rivista
Current status and recent advances in reirradiation of glioblastoma / Minniti, G.; Niyazi, M.; Alongi, F.; Navarria, P.; Belka, C.. - In: RADIATION ONCOLOGY. - ISSN 1748-717X. - 16:1(2021). [10.1186/s13014-021-01767-9]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1676381
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