Effectiveness of Stereotactic Radiotherapy and Bevacizumab for Recurrent High-Grade Gliomas: A Potential Therapy for Isocitrate Dehydrogenase Wild-Type Recurrent High-Grade Gliomas.

Abstract:

OBJECTIVE: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:Data for patients with recurrent HGGs 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 3 groups: in-field, marginal, and out-field. RESULTS:The median overall survival 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 wild-type tumors, the SRT-Bv treatment significantly prolonged survival more than the Bv treatment (10.9 vs. 8.2 months; P = 0.01). The World Health Organization 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 radiologic findings, 6 cases (21%); and uncertain, 2 cases (7%). CONCLUSIONS:SRT-Bv treatment significantly prolonged survival duration more than Bv treatment and provides good local control in patients with recurrent HGGs, especially those with isocitrate dehydrogenase wild-type tumors.

journal_name

World Neurosurg

journal_title

World neurosurgery

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

doi

10.1016/j.wneu.2018.03.161

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

e1138-e1146

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(18)30643-0

journal_volume

114

pub_type

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