García-Cabezas S, Rivin del Campo E, Solivera-Vela J, Palacios-Eito A. Re-irradiation for high-grade gliomas: Has anything changed? World J Clin Oncol 2021; 12(9): 767-786 [PMID: 34631441 DOI: 10.5306/wjco.v12.i9.767]
Corresponding Author of This Article
Amalia Palacios-Eito, MD, PhD, Associate Professor, Chief Doctor, Department of Radiation Oncology, Reina Sofia University Hospital, Avda. Menéndez Pidal, s/n, Cordoba 14004, Spain. amalia.palacios.sspa@juntadeandalucia.es
Research Domain of This Article
Oncology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Sep 24, 2021; 12(9): 767-786 Published online Sep 24, 2021. doi: 10.5306/wjco.v12.i9.767
Re-irradiation for high-grade gliomas: Has anything changed?
Sonia García-Cabezas, Eleonor Rivin del Campo, Juan Solivera-Vela, Amalia Palacios-Eito
Sonia García-Cabezas, Amalia Palacios-Eito, Department of Radiation Oncology, Reina Sofia University Hospital, Cordoba 14004, Spain
Eleonor Rivin del Campo, Department of Radiation Oncology, Tenon University Hospital, Paris 75020, France
Juan Solivera-Vela, Department of Neurosurgery, Reina Sofia University Hospital, Cordoba 14004, Spain
Author contributions: All authors contributed to the writing and revision of this manuscript.
Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amalia Palacios-Eito, MD, PhD, Associate Professor, Chief Doctor, Department of Radiation Oncology, Reina Sofia University Hospital, Avda. Menéndez Pidal, s/n, Cordoba 14004, Spain. amalia.palacios.sspa@juntadeandalucia.es
Received: June 2, 2021 Peer-review started: June 2, 2021 First decision: July 16, 2021 Revised: July 21, 2021 Accepted: July 30, 2021 Article in press: July 30, 2021 Published online: September 24, 2021
Abstract
Optimal management after recurrence or progression of high-grade gliomas is still undefined and remains a challenge for neuro-oncology multidisciplinary teams. Improved radiation therapy techniques, new imaging methods, published experience, and a better radiobiological knowledge of brain tissue have positioned re-irradiation (re-RT) as an option for many of these patients. Decisions must be individualized, taking into account the pattern of relapse, previous treatment, and functional status, as well as the patient’s preferences and expected quality of life. Many questions remain unanswered with respect to re-RT: Who is the most appropriate candidate, which dose and fractionation are most effective, how to define the target volume, which imaging technique is best for planning, and what is the optimal timing? This review will focus on describing the most relevant studies that include re-RT as salvage therapy, with the aim of simplifying decision-making and designing the best available therapeutic strategy.
Core Tip: The optimal management after recurrence or progression of high-grade gliomas is still undefined. Improved radiation therapy techniques, new imaging methods, published experience, as well as better radiobiological knowledge of the brain tissue have positioned re-irradiation as a valid alternative for many of these patients. Many questions remain unanswered. This review will focus on describing the most relevant studies that include re-irradiation as salvage treatment, with the aim of simplifying decision-making and designing the best available therapeutic strategy.
