Session Item

Re-irradiation is an option for the treatment of high-grade gliomas recurrence. However, there is no recommendation regarding dose, fractionation or target volume. Our retrospective monocentric study aims to analyze progression-free survival (PFS), overall survival (OS) and the tolerance of glioblastoma re-irradiation.

We identified all patients treated by re-irradiation for high-grade glioma between 2014 and 2021 at Bordeaux University Hospital. Evaluation included overall survival, progression-free survival, and treatment-related toxicities. For each patient, IDH status and Bevacizumab association were detailed.

42 patients (median age 59 years [31; 75]; median WHO 1) were retreated for high-grade glioma recurrence (IDH-negative 78.5%). Median time between initial irradiation and re-irradiation was 12.7 months [1.7-314]. Median re-irradiation dose was 30 Gy [18-62.7] with a median volume (PTV) of 12.3 cm³ [0.4-299]. Median OS after re-irradiation was 14.3 months [8.5; 20.1] and median PFS was 4.7 months [3; 6.5]. Radionecrosis was observed in 17 patients (40%), with only 2 symptomatic patients: headaches grade 2 and epileptic fit grade 3. Median OS of patients treated prior to re-irradiation with Bevacizumab was 4.9 months and median PFS was 2.6 months. When Bevacizumab was used during or after radiotherapy, median OS after re-irradiation was 15.8 months and median PFS was 6.2 months.

Re-irradiation of high-grade gliomas is a well-tolerated treatment with encouraging results for patients with IDH-negative glioblastomas.