Re-Irradiation in Recurrent High-Grade Glioma

Background and Purpose: Despite the progress in treatment modalities such as neurosurgery and radiotherapy, almost all patients treated with malignant gliomas develop recurrent tumors and die of their disease. The aim of this study was to determine response, survival and treatment toxicities after re-irradiation of relapsing primary malignant brain gliomas.Material and Methods: Twenty patients with recurrent or progressive primary brain glioma were subjected to re irradiation. 3-D conformal radiotherapy with a median target total dose of 35 Gy (BED = 66.5 GY2) was applied using 1.8-2 Gy daily; 5 days per week with a 6 MV linear accelerator.Results: Patients were assessed as regard response, survival and treatment complications. Median progression free and overall survival was 3 and 9 months respectively. As regard subjective response; 50% of cases showed improvement symptoms. Radiographic indices were stabilized or improved in about 60% of patients. Brain necrosis was noted in 10% of patients.Conclusion: Re-irradiation of recurrent brain gliomas allows the survival prolongation and delays disease progression or recurrence, with acceptable toxicities.