External beam re-irradiation, combination chemoradiotherapy, and particle therapy for the treatment of recurrent glioblastoma

Expert Review of Anticancer Therapy
Neil K TaunkGustavo N Marta

Abstract

Glioblastoma is a common aggressive primary malignant brain tumor, and is nearly universal in progression and mortality after initial treatment. Re-irradiation presents a promising treatment option for progressive disease, both palliating symptoms and potentially extending survival. Highly conformal radiation techniques such as stereotactic radiosurgery and hypofractionated radiosurgery are effective short courses of treatment that allow delivery of high doses of therapeutic radiation with steep dose gradients to protect normal tissue. Patients with higher performance status, younger age, and longer interval between primary treatment and progression represent the best candidates for re-irradiation. Multiple studies are also underway involving combinations of radiation and systemic therapy to bend the survival curve and improve the therapeutic index. In the multimodal treatment of recurrent high-grade glioma, the use of surgery, radiation, and systemic therapy should be highly individualized. Here we comprehensively review radiation therapy and techniques, along with discussion of combination treatment and novel strategies.

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Citations

Mar 14, 2019·Mathematical Medicine and Biology : a Journal of the IMA·Kelsey Maass, Minsun Kim
Oct 12, 2017·Journal of Oncology Practice·Joo Yeon Nam, John F de Groot
Oct 14, 2019·Current Oncology Reports·Caroline Chaul-Barbosa, Daniel Fernandes Marques
Jul 11, 2020·Pathology Oncology Research : POR·Ágnes DobiKatalin Hideghéty
Dec 8, 2020·Surgical Neurology International·Juliana Guimaraes SantosClovis O da Fonseca

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