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

Table 4 Summary of selected publications reporting re-irradiation plus bevacizumab as salvage treatment in recurrent high-grade gliomas

Ref.	Study type	No. patients	Histology	Re-irradiation			Median interval	Median tumor volume	Median PFS2	Median OS2	Severe toxicity	Radionecrosis
				Total dose, median	Dose/fr, median	EQD2
Gutin et al[56], 2009	P	25	20 GBM, 5 G3G	30 Gy	6 Gy	60 Gy	14.5 mo	34 mL	7.3 mo	12.5 mo	G3: 1 hemorrhage; G4: 3 (1 bowel perforation, 1 wound dehiscence and 1 GI bleed)	0%
Cuneo et al[54], 2012	R	63 (41 BEV)	49 GBM, 8 G3G, 6 prior G2G	15 Gy	15 Gy	63.8 Gy	21 mo	4.8 mL	GBM: 5.2 mo (BEV) vs 2.1 mo (without BEV). 6 mo whole series	GBM: 11.2 mo (BEV) vs 3.9 mo (without BEV). 10 mo whole series	11%	10%
Niyazi et al[52], 2012	R	30 (20 BEV)	22 GBM, 8 G3G	36 Gy	2 Gy	36 Gy	NR	NR	8 mo	Mean 12 mo	G3:1; G4: 1 wound dehiscence	0%
Shapiro et al[112], 2013	R	24	20 GBM, 1 G3G, 3 G2G	30 Gy	6 Gy	60 Gy	12.6 mo	35.3 mL	7.5 mo (6.8 mo GBM)	12.2 mo (whole series and GBM)	Toxicity BEV: G4: 12.5%	0%
Cabrera et al[113], 2013	P	15	8 GBM, 7 G3G	18 Gy. 25 Gy	18 Gy. 5 Gy	90 Gy. 43.8 Gy	20 mo	NR (< 5 cm)	3.9 mo	14.4 mo	G3:1	0%
Flieger et al[57], 2014	P	71 (57 BEV)	52 GBM, 19 G3G and G2G	36 Gy	2 Gy	36 Gy	NR	NR	5.6 mo (BEV) vs 2.5 mo (without BEV)	GBM: 9.3 mo (BEV) vs 6.1 mo (without BEV)	Toxicity BEV: G4: 5.3%	4.2% (BEV) by image or histologically

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