Journal Article

DKFZ-2023-01517

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Outcomes of Isocitrate Dehydrogenase Wild Type Glioblastoma after Re-irradiation.

Ehret, F.DKFZ* ; Wolfgang, J. ; Allwohn, L. ; Onken, J. ; Wasilewski, D. ; Roohani, S.DKFZ* ; Oertel, J. ; Zips, D.DKFZ* ; Kaul, D.DKFZ*

2023
Elsevier Amsterdam

This record in other databases:

Please use a persistent id in citations: doi:10.1016/j.ctro.2023.100653

Abstract: Glioblastomas (GBM) are the most common malignant primary brain tumors in adults and have a dismal prognosis. Patients frequently suffer from local tumor recurrences, with limited therapeutic options. Re-irradiation represents a possible intervention, but given the recent 5th edition of the World Health Organization classification of central nervous system tumors, studies in isocitrate dehydrogenase wild type (IDH-wt) cohorts undergoing a second course of radiotherapy remain limited. Herein, we sought to describe our institutional experience and outcomes after GBM IDH-wt re-irradiation.GBM patients with confirmed IDH-wt status undergoing re-irradiation were included in this single-center, retrospective analysis.A total of 88 patients were analyzed. The median clinical and radiographic follow-up periods were 4.6 months and 4.4 months, respectively. Most patients had a Karnofsky performance status of at least 80% (n = 57). The median biologically effective dose and 2 Gy equivalent dose (EQD2) for re-irradiations, assuming an α/β ratio of 10 Gy for GBM, were 51.4 and 42.8 Gy, respectively. In total, 71 deaths were recorded. The median overall survival (OS) was 8.0 months. Multivariable Cox regression of OS revealed a positive influence of gross total resection vs. biopsy or no resection (hazard ratio: 0.43, p = 0.02). The median progression-free survival (PFS) was 5.9 months. The multivariable Cox regression for PFS did not detect any significant factors. No clear evidence of radiation necrosis was recorded during the available follow-up. However, only a minority (n = 4) of patients underwent surgery after re-irradiation, none showing histopathological proof of radiation necrosis.The prognosis for recurrent IDH-wt GBM after re-irradiation is poor. Patients who are amenable and able to undergo re-resection may have a favorable OS. A second course of radiotherapy with a moderate cumulative EQD2 and small- to medium-sized planning target volumes appeared safe regarding the occurrence of radiation necrosis.

Keyword(s): Glioblastoma ; IDH ; Isocitrate Dehydrogenase ; Radiation Necrosis ; Radionecrosis ; Radiotherapy ; Re-irradiation

---

Contributing Institute(s):

1. DKTK Koordinierungsstelle Berlin (BE01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2023

---

Database coverage:
; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DOAJ Seal ; Essential Science Indicators ; Fees ; IF < 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

---