Abstract：Objective To analyze the long-term efficacy and safety of re-irradiation for recurrent glioma. Methods The data of 52 patients with recurrent gliomas were collected from 2009 to 2019. The median planned targetvolume (PTV) was 73.5 cm3(49.9-102.7 cm3) and the median dose was 45.0 Gy (43.0-48.8 Gy). Kaplan-Meier method was used for survival assessment,log-rank test for difference assessment,and Cox's regression model for multivariate prognostic analysis. Results The median follow-up time was 32.6 months. The median overall survival (OS) and progression-free survival (PFS) time were 16.1 months (95%CI,4.1-28.1) and 8.0 months (95%CI,4.0-12.0). The 1-, 2-and 3-year survival rates were 67%,43% and 29%, respectively. The 6-month,1-year and 2-year PFS rates were 67%,40%,26%, respectively. Multivariate analysis showed that KPS score and recurrence time significantly affected the OS (P=0.012,P=0.001). KPS score and time interval between two radiotherapies significantly impacted the PFS (P=0.003,P=0.018). Stratified analysis showed that KPS score was the independent prognostic factor of OS and PFS in patients with WHO grade Ⅱ initial pathology and reoperation after recurrence (P<0.001,P=0.012);clinical manifestation was the independent prognostic factor of OS and PFS in patients with WHO grade Ⅲ and Ⅳ initial pathology (P=0.006,P=0.044). The overall incidence of adverse reactions was 30.8%. Grade 1 adverse reactions accounted for 25.0%,and 5.8% for grade 2. Conclusions Re-irradiation for recurrent glioma yields good long-term clinical efficacy and tolerable adverse reactions.
Lyu Shuang,Zhang Haibo,Xu Ying et al. Analysis of long-term efficacy of re-irradiation for recurrent glioma[J]. Chinese Journal of Radiation Oncology, 2020, 29(6): 411-415.
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