Re-irradiation of recurrent gliomas: pooled analysis and validation of an established prognostic score—report of the Radiation Oncology Group (ROG) of the German Cancer Consortium (DKTK)

The heterogeneity of high-grade glioma recurrences remains an ongoing challenge for the interdisciplinary neurooncology team. Response to re-irradiation (re-RT) is heterogeneous, and survival data depend on prognostic factors such as tumor volume, primary histology, age, the possibility of reresecti...

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Main Authors: Combs, Stephanie (Author) , Adeberg, Sebastian (Author) , Bougatf, Nina (Author) , Debus, Jürgen (Author)
Format: Article (Journal)
Language:English
Published: 23 March 2018
In: Cancer medicine
Year: 2018, Volume: 7, Issue: 5, Pages: 1742-1749
ISSN:2045-7634
DOI:10.1002/cam4.1425
Online Access:Verlag, Volltext: https://doi.org/10.1002/cam4.1425
Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/cam4.1425
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Author Notes:Stephanie E. Combs, Maximilian Niyazi, Sebastian Adeberg, Nina Bougatf, David Kaul, Daniel F. Fleischmann, Arne Gruen, Emmanouil Fokas, Claus M. Rödel, Franziska Eckert, Frank Paulsen, Oliver Oehlke, Anca-Ligia Grosu, Annekatrin Seidlitz, Annika Lattermann, Mechthild Krause, Michael Baumann, Maja Guberina, Martin Stuschke, Volker Budach, Claus Belka, Jürgen Debus, & Kerstin A. Kessel
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Summary:The heterogeneity of high-grade glioma recurrences remains an ongoing challenge for the interdisciplinary neurooncology team. Response to re-irradiation (re-RT) is heterogeneous, and survival data depend on prognostic factors such as tumor volume, primary histology, age, the possibility of reresection, or time between primary diagnosis and initial RT and re-RT. In the present pooled analysis, we gathered data from radiooncology centers of the DKTK Consortium and used it to validate the established prognostic score by Combs et al. and its modification by Kessel et al. Data consisted of a large independent, multicenter cohort of 565 high-grade glioma patients treated with re-RT from 1997 to 2016 and a median dose of 36 Gy. Primary RT was between 1986 and 2015 with a median dose of 60 Gy. Median age was 54 years; median follow-up was 7.1 months. Median OS after re-RT was 7.5, 9.5, and 13.8 months for WHO IV, III, and I/II gliomas, respectively. All six prognostic factors were tested for their significance on OS. Aside from the time from primary RT to re-RT (P = 0.074) and the reresection status (P = 0.101), all factors (primary histology, age, KPS, and tumor volume) were significant. Both the original and new score showed a highly significant influence on survival with P < 0.001. Both prognostic scores successfully predict survival after re-RT and can easily be applied in the routine clinical workflow. Now, further prognostic features need to be found to even improve treatment decisions regarding neurooncological interventions for recurrent glioma patients.
Item Description:Gesehen am 05.06.2019
Physical Description:Online Resource
ISSN:2045-7634
DOI:10.1002/cam4.1425