Abstract
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.
Highlights
The heterogeneity of glioma recurrences remains an ongoing challenge for the interdisciplinary neurooncology team
Response to re-irradiation 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-R T from 1997 to 2016 and a median dose of 36 Gy
Summary
The heterogeneity of glioma recurrences remains an ongoing challenge for the interdisciplinary neurooncology team. We analyzed patients with recurrent high-grade gliomas treated for re-RT and developed a prognostic score for outcome [14, 15]. In the present pooled analysis, we gathered data from nine large German radiooncology centers of the German Cancer Consortium—Radiation Oncology group DKTK- ROG (Deutsches Konsorium für Tranlationale Forschung, DKTK). This large independent, multicenter cohort of 565 patients was used to determine the outcome after re-RT and to validate the established prognostic score by Combs et al [14] and its modification [15]
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