title: Re-Irradiation for Recurrent Gliomas: Treatment Outcomes and Prognostic Factors.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of re-irradiation in patients with recurrent gliomas and to identify subgroups for whom re-irradiation for recurrent gliomas is most beneficial.
  
  
  METHODS
  We retrospectively reviewed 36 patients with recurrent or progressive gliomas who received re-irradiation between January 1996 and December 2011. Re-irradiation was offered to recurrent glioma patients with good performance or at least 6 months had passed after initial radiotherapy (RT), with few exceptions.
  
  
  RESULTS
  Median doses of re-irradiation and initial RT were 45.0 Gy and 59.4 Gy, respectively. The median time interval between initial RT and re-irradiation was 30.5 months. Median overall survival (OS) and the 12-month OS rate were 11 months and 41.7%, respectively. In univariate analysis, Karnofsky performance status (KPS) ≥70 (p<0.001), re-irradiation dose ≥45 Gy (p=0.040), and longer time interval between initial RT and re-irradiation (p=0.040) were associated with improved OS. In multivariate analysis, KPS (p=0.030) and length of time interval between initial RT and re-irradiation (p=0.048) were important predictors of OS. A radiographically suspected mixture of radiation necrosis and progression after re-irradiation was seen in 5 patients.
  
  
  CONCLUSIONS
  Re-irradiation in conjunction with surgery could be a salvage treatment for selected recurrent glioma patients with good performance status and recurrence over a long time.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jeongshim
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jaeho
authors.initials: J
authors.lastname: Cho
authors.affiliation: Department of Neurosurgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea. changjh@yuhs.ac.
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea. cosuh317@yuhs.ac.
authors.forename: Chang Ok
authors.initials: CO
authors.lastname: Suh
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005910:Glioma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D000069475:Re-Irradiation; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Re-irradiation; prognostic factor; recurrent glioma; survival