Journal article
Re-resection for recurrent high-grade glioma in the setting of re-irradiation: more is not always better
Journal of neuro-oncology, v 124(2), pp 215-221
01 Sep 2015
PMID: 26024653
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The optimal treatment for patients with recurrent high grade glioma (HGG) remains controversial. Available therapies include surgery, re-irradiation, alternating electric fields or systemic therapy. Here we investigate whether re-resection will improve survival in patients receiving repeat radiotherapy for tumor recurrence. 231 consecutive patients with recurrent HGG treated with re-irradiation between 1994 and 2012 were analyzed. 105 patients underwent re-resection. Re-irradiation was delivered using daily fractions of 3.5 Gy to a median total dose of 35 Gy. Survival was then analyzed comparing patients with and without re-resection. Overall survival (OS) and survival from the first recurrence are reported. Univariate and cox-proportional hazard modeling was performed in a step-wise multivariate analysis using known prognostic factors. The median follow-up time from initial diagnosis was 25.7 months. The median OS from initial diagnosis of the entire group was 22.5 months. There was no significant difference in median overall survival between patients who received re-resection versus no re-resection, 23 versus 21.9 months respectively (p = 0.6). Additionally, there was no difference in median survival from the time of first recurrence 10.5 months without re-resection versus 11.1 months with re-resection (p = 0.09). After adjusting for known prognostic variables, only age remained significant. Re-irradiation is an effective salvage therapy for patients with localized, progressive high grade glioma, achieving a median survival of 10-11 months from re-irradiation. Our data reveals no significant improvement in survival with the addition of re-resection to re-irradiated patients with HGG.
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Details
- Title
- Re-resection for recurrent high-grade glioma in the setting of re-irradiation: more is not always better
- Creators
- Joshua D. Palmer - Sidney Kimmel Cancer CenterJoshua Siglin - UPMC Hillman Cancer CenterKosj Yamoah - Sidney Kimmel Cancer CenterTu Dan - Sidney Kimmel Cancer CenterColin E. Champ - UPMC Hillman Cancer CenterVoichita Bar-Ad - Thomas Jefferson UniversityMaria Werner-Wasik - Thomas Jefferson UniversityJames J. Evans - Sidney Kimmel Cancer CenterLyndon Kim - Sidney Kimmel Cancer CenterJon Glass - Sidney Kimmel Cancer CenterChristopher Farrell - Sidney Kimmel Cancer CenterDavid W. Andrews - Sidney Kimmel Cancer CenterWenyin Shi - Thomas Jefferson University
- Publication Details
- Journal of neuro-oncology, v 124(2), pp 215-221
- Publisher
- Springer Nature
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000361883000008
- Scopus ID
- 2-s2.0-84942500077
- Other Identifier
- 991021897395004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Oncology