% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Ehret:277806,
      author       = {F. Ehret$^*$ and J. Wolfgang and L. Allwohn and J. Onken
                      and D. Wasilewski and S. Roohani$^*$ and J. Oertel and D.
                      Zips$^*$ and D. Kaul$^*$},
      title        = {{O}utcomes of {I}socitrate {D}ehydrogenase {W}ild {T}ype
                      {G}lioblastoma after {R}e-irradiation.},
      journal      = {Clinical and translational radiation oncology},
      volume       = {42},
      issn         = {2405-6308},
      address      = {Amsterdam},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2023-01517},
      pages        = {100653},
      year         = {2023},
      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.},
      keywords     = {Glioblastoma (Other) / IDH (Other) / Isocitrate
                      Dehydrogenase (Other) / Radiation Necrosis (Other) /
                      Radionecrosis (Other) / Radiotherapy (Other) /
                      Re-irradiation (Other)},
      cin          = {BE01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37502699},
      pmc          = {pmc:PMC10369398},
      doi          = {10.1016/j.ctro.2023.100653},
      url          = {https://inrepo02.dkfz.de/record/277806},
}