% 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{Grosu:307436,
author = {A.-L. Grosu$^*$ and W. A. Weber and E. Graf and M. Mix and
U. Nestle and T. Schimek-Jasch and R. Wiehle and I. Mader
and U. Würtemberger and K.-J. Langen and M. Niyazi and F.
Paulsen and L. König and F. A. Giordano and I. Spehl and D.
Bernhardt and M. M. Schymalla and C. Pöttgen and S. Semrau
and T. Brunner and B. Hültenschmidt and B. J. Krause and I.
F. Ciernik and J. Beck and B. G. Baumert and P. T. Meyer$^*$
and H. Urbach and I. Popp},
collaboration = {G. S. Group},
othercontributors = {C. Belka and F. Eckert and M. J. Eble and E. Sperk and F.
Momm and S. E. Combs and B. Wiestler and R.
Engenhart-Cabillic and M. Stuschke and R. Fietkau and S.
Nadji and G. Hildebrandt and A. Chakravarti and S. C. Short
and C. Nieder and S. Schneider-Fuchs and M. Prinz},
title = {{O}-(2-[18{F}]fluoroethyl)-{L}-tyrosine-{PET}-guided versus
contrast-enhanced {T}1-weighted {MRI}-guided re-irradiation
in patients with recurrent glioblastoma ({GLIAA}/{NOA}-10
{ARO}2013-01): a multicentre, open-label, randomised trial.},
journal = {The lancet / Oncology},
volume = {nn},
issn = {1470-2045},
address = {London},
publisher = {The Lancet Publ. Group},
reportid = {DKFZ-2025-03035},
pages = {nn},
year = {2025},
note = {epub},
abstract = {O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET has a higher
specificity than contrast-enhanced T1-weighted MRI
(CE-T1MRI) in diagnosing recurrent glioblastoma. We aimed to
evaluate whether a FET-PET-based target volume delineation,
compared with CE-T1MRI, improves outcomes in patients with
recurrent glioblastoma scheduled for re-irradiation.GLIAA
was a multicentre, open-label, parallel randomised study
done in 15 radiation oncology centres in Germany. Patients
aged 18 years or older with a Karnofsky performance score
greater than $60\%$ and a macroscopic WHO grade IV recurrent
glioblastoma (1-6 cm) were randomly assigned (1:1) to
receive either FET-PET-based or CE-T1MRI-based target volume
delineation followed by re-irradiation with 39 Gy in 13
fractions. Randomisation was performed centrally, using a
minimisation technique with a random element and a
computer-assisted randomisation tool, stratified by time
since first radiotherapy, previous chemotherapy, tumour
diameter, MGMT status, and planned chemotherapy. The primary
endpoint was progression-free survival from randomisation,
assessed in the per-protocol population (patients who
initiated treatment per their assigned group). Adverse
events were systematically assessed in all patients who
commenced therapy. The trial was registered with
ClinicalTrials.gov (NCT01252459), German Clinical Trials
Registry (DRKS00000634), and European Clinical Trials
Database (EudraCT 2012-001121-27), and is completed.Between
Nov 22, 2013, and Aug 18, 2021, 271 patients were recruited
and screened for eligibility, 200 of whom were randomly
assigned to re-irradiation based on FET-PET (n=100) or
CE-T1MRI (n=100). 85 $(43\%)$ participants were female and
115 $(58\%)$ were male. 98 patients in the FET-PET group and
97 in the CE-T1MRI group were treated per protocol. Median
follow-up for censored patients was 12·2 months (IQR
6·6-20·7). Median progression-free survival was 4·0
months $(95\%$ CI 3·7-5·2) in the FET-PET group and 4·9
months (3·7-6·0) in the CE-T1MRI group (one-sided
stratified log-rank p=0·98; adjusted hazard ratio 1·14
$[95\%$ CI 0·85-1·52]; p=0·39; median follow-up for six
censored patients 4·1 months [IQR 2·3-6·6]). The most
common grade 3-4 adverse event was radionecrosis (eight
$[8\%]$ of 99 in the FET-PET group vs seven $[7\%]$ of 99 in
the CE-T1MRI group). Acute and subacute serious adverse
events occurred in 15 $(15\%)$ of 99 patients in each group;
possibly re-irradiation-related late serious adverse events
occurred in ten $(10\%)$ of 97 patients in the FET-PET group
and 18 $(19\%)$ of 96 in the CE-T1MRI group. There were no
treatment-related deaths.FET-PET-based target volume
delineation for re-irradiation did not lead to a significant
clinical benefit compared with CE-T1MRI-based treatment in
patients with recurrent glioblastoma. Thus, CE-T1MRI remains
the preferred delineation method in this setting.Deutsche
Krebshilfe.},
cin = {FR01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41429128},
doi = {10.1016/S1470-2045(25)00642-4},
url = {https://inrepo02.dkfz.de/record/307436},
}