title: Recurrent malignant gliomas.
abstract: In almost all patients, malignant glioma recurs following initial treatment with maximal safe resection, conformal radiotherapy, and temozolomide. This review describes the many options for treatment of recurrent malignant gliomas, including reoperation, alternating electric field therapy, chemotherapy, stereotactic radiotherapy or radiosurgery, or some combination of these modalities, presenting the evidence for each approach. No standard of care has been established, though the antiangiogenic agent, bevacizumab; stereotactic radiotherapy or radiosurgery; and, perhaps, combined treatment with these 2 modalities appear to offer modest benefits over other approaches. Clearly, randomized trials of these options would be advantageous, and novel, more efficacious approaches are urgently needed.
authors.affiliation: Department of Radiation Oncology, Duke Cancer Institute, Durham, NC; Department of Surgery, Duke Cancer Institute, Durham, NC. Electronic address: john.kirkpatrick@dm.duke.edu.
authors.forename: John P
authors.initials: JP
authors.lastname: Kirkpatrick
authors.affiliation: Department of Radiation Oncology, Duke Cancer Institute, Durham, NC; Department of Surgery, Duke Cancer Institute, Durham, NC.
authors.forename: John H
authors.initials: JH
authors.lastname: Sampson
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D005910:Glioma / Q000628:therapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D016634:Radiosurgery / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods; D012086:Reoperation / Q000379:methods
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab