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Reirradiation of recurrent glioblastoma: results from a single-center retrospective cohort study

Purpose - The management of recurrent glioblastoma (rGBM) remains a clinical challenge, with only limited therapeutic options available to date. Reirradiation may offer a progression-free survival (PFS) benefit in selected cases, but data are scarce. - Methods - Consecutive patients from the last 10...

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Main Authors: Dejonckheere, Cas S. (Author) , Zeyen, Thomas (Author) , Duffy, Cathrina (Author) , Layer, Yannik C. (Author) , Potthoff, Anna-Laura (Author) , Wichtmann, Barbara D. (Author) , Friker, Lea L. (Author) , Scafa, Davide (Author) , Leitzen, Christina (Author) , Nour, Younèss (Author) , Kugel, Fabian (Author) , Schäfer, Niklas (Author) , Radbruch, Alexander (Author) , Vatter, Hartmut (Author) , Grosu, Anca-Ligia (Author) , Herrlinger, Ulrich (Author) , Schneider, Matthias (Author) , Giordano, Frank Anton (Author) , Sarria, Gustavo R. (Author) , Gkika, Eleni (Author) , Layer, Julian (Author)
Format: Article (Journal)
Language:English
Published: November 2025
In: Clinical and translational radiation oncology
Year: 2025, Volume: 55, Pages: 1-8
ISSN:2405-6308
DOI:10.1016/j.ctro.2025.101029
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ctro.2025.101029
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2405630825001211
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Author Notes:Cas S. Dejonckheere, Thomas Zeyen, Cathrina Duffy, Yannik C. Layer, Anna-Laura Potthoff, Barbara D. Wichtmann, Lea L. Friker, Davide Scafa, Christina Leitzen, Younèss Nour, Fabian Kugel, Niklas Schäfer, Alexander Radbruch, Hartmut Vatter, Anca-Ligia Grosu, Ulrich Herrlinger, Matthias Schneider, Frank A. Giordano, Gustavo R. Sarria, Eleni Gkika, Julian P. Layer
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Summary:Purpose - The management of recurrent glioblastoma (rGBM) remains a clinical challenge, with only limited therapeutic options available to date. Reirradiation may offer a progression-free survival (PFS) benefit in selected cases, but data are scarce. - Methods - Consecutive patients from the last 10 years with GBM (CNS WHO grade 4, IDH-wildtype) who underwent at least one additional course of cranial radiotherapy for suspected or histopathologically confirmed rGBM at a tertiary neuro-oncological center were retrospectively analyzed. The primary endpoint was PFS, secondary endpoints included reirradiation-related adverse event rates, with a particular focus on radiation necrosis (RN). - Results - Fifty-nine patients were included with a median follow-up (range) of 8.7 (0.5-48.0) months after reirradiation. The median time to first recurrence was 15 (4-89) months, with the majority occurring in-field (59.7 %). The EQD2⍺/β=10 ranged from 31.3-80.2 Gy with a median prescription dose of 42 Gy. Reirradiation was combined with systemic therapy in 81.4 % of patients. No grade 3-5 acute reirradiation-related adverse events were observed. RN was diagnosed in 16.9 % of patients (80 % grade 2 and 20 % grade 3), with a notably low rate in those receiving anti-VEGF therapy parallel to reirradiation. RN risk was independent of reirradiation volume or dose (p = 0.15 and 0.43, respectively). The disease control rate following reirradiation was 83.6 % and the median PFS was 5.9 (0.5-48.0) months. Concomitant chemotherapy or anti-VEGF therapy was significantly associated with improved outcomes (p = 0.049), whereas smaller reirradiation volumes demonstrated a non-significant trend towards longer PFS (p = 0.23). - Conclusion - In this retrospective analysis, reirradiation for rGBM was feasible and safe, conferring a potential PFS benefit in selected patients. Bevacizumab emerged as a particularly promising combination partner, contributing to both RN prevention and enhanced efficacy.
Item Description:Online verfügbar: 8. August 2025, Artikelversion: 9. August 2025
Gesehen am 17.11.2025
Physical Description:Online Resource
ISSN:2405-6308
DOI:10.1016/j.ctro.2025.101029

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