Re-irradiation for high-grade gliomas: Has anything changed?

Table 3 Summary of selected publications reporting re-irradiation plus temozolomide as salvage treatment in recurrent high-grade gliomas

Ref.	Study type	No. patients	Histology	Re-irradiation			Median interval	Median tumor volume	Median PFS2/actuarial PFS2	Median OS2/actuarial OS2	Severe toxicity	Radionecrosis
				Total dose, median	Dose/fr, median	EQD2
Grosu et al[49], 2005	P	44 (TMZ 29)	34 GBM, 2 Gliosarcomas, 8 G3G	30 Gy	5 Gy	52.5 Gy	16 mo	15 mL	NR	8 mo (11 mo RT + TMZ vs 6 mo without TMZ)	0%	0%
Combs et al[81], 2008	R	25	8 GBM, 10 G3G, 7 G2G	36 Gy	2 Gy	36 Gy	36 mo	50 mL	5 mo; 16% at 12 mo	8 mo; 25% at 12 mo	0%	NR
Minniti et al[45], 2011	R	36	All GBM	37.5 Gy	2.5 Gy	42.2 Gy	14 mo	13.1 mL	5 mo; 8% at 12 mo	9.7 mo; 33% at 12 mo	Thrombocytopenia G3: 2.8%	8% by image
Conti et al[47], 2012	R	23 (TMZ 12)	All GBM	20 Gy	10 Gy	60 Gy	7 mo	< 30 mL	7 mo (TMZ) vs 4 mo (no TMZ)	12 mo (TMZ) vs 7 mo (without TMZ)	≥ G3 hematological toxicity > 40%	4.3%
Minniti et al[46], 2013	R	54	38 GBM, 16 G3G	30 Gy	6 Gy	60 Gy	15.5 mo	9.8 mL	6 mo (4 mo GBM)	12.4 mo (11.4 mo GBM)	Thrombocytopenia G3: 3.7%, leukopenia G3: 3.7%	7% by image
Greenspoon et al[111], 2014	P	31	All GBM	30 Gy	5 Gy	52.5 Gy	At least 6 mo	12 mL	7 mo	9 mo	NR	G3: 9.6%, G4: 3.2%
Aktan et al[48], 2015	R	21 (17 TMZ)	18 GBM, 3 G3G	54 Gy	2 Gy	54 Gy	39.4 mo	Recurrent tumor size was median 5.5 cm	NR	18 mo (G3G) and 14.1 mo (GBM)	0%	0%

α/β = 2; EQD2: Equivalent dose at 2 Gy fractions; G2G: Grade II glioma; G3G: Grade III glioma; G: Grade; GBM: Glioblastoma; NR: Not reported; OS2: Overall survival from re-irradiation; P: Prospective; R: Retrospective; PFS2: Progression free survival from re-irradiation; TMZ: Temozolomide.