Effectiveness of Stereotactic Radiotherapy and Bevacizumab for Recurrent High-grade gliomas -A Potential Therapy for IDH Wild-type Recurrent High-grade Gliomas.
World Neurosurg. 2018 Mar 31;:
Authors: Yasuda T, Muragaki Y, Nitta M, Miyamoto K, Oura Y, Henmi T, Noguchi S, Oda H, Saito T, Maruyama T, Atsuchi S, Miura N, Kawamata T
Abstract
OBJECT: This study aimed to evaluate the efficacy of stereotactic radiotherapy combined with bevacizumab (SRT-Bv) compared with Bv treatment for recurrent high-grade gliomas (HGGs).
METHODS: Herein, data for patients with recurrent HGG who received SRT and Bv (n = 29) or Bv (n = 29) between June 2014 and September 2016 were retrospectively analyzed. All patients received conventional radiotherapy (total 60 Gy) before this study. SRT was administered at a median dose of 42 Gy in 3-7 fractions. The recurrence pattern was classified into three groups: in-field, marginal, and out-field.
RESULTS: The median overall survival (OS) in the SRT-Bv group was significantly longer than that in the Bv group (10.4 vs. 5.6 months; p = 0.02). In patients with isocitrate dehydrogenase (IDH) wild-type tumors, the SRT-Bv treatment significantly prolonged survival than the Bv treatment (10.9 vs. 8.2 months; p = 0.01). The WHO grade and presence or absence of SRT were significant prognostic factors in the univariate analysis. Besides brain edema in 2 cases and asymptomatic subdural hematoma in 1 case, no other severe adverse effect due to SRT-Bv treatment was recorded. The pattern of recurrence was as follows: in-field, 2 cases (7%); marginal, 8 cases (28%); out-field, 11 cases (38%); no recurrence on radiological findings, 6 cases (21%); and uncertain, 2 cases (7%).
CONCLUSIONS: SRT-Bv treatment significantly prolonged survival duration than Bv treatment and provides good local control in patients with recurrent HGGs, especially those with IDH wild-type.
PMID: 29614360 [PubMed - as supplied by publisher]
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