Table 4 Overview of published results on hypofractionated stereotactic radiotherapy (HFSRT) in patients with recurrent malignant glioma (RT: radiotherapy).
From: Hypofractionated stereotactic re-irradiation: treatment option in recurrent malignant glioma
authors | patient number | single dose (Gy) | total dose (Gy) | median tumor volume (ml) | chemo-therapy | overall survival (median) | surgery for toxicity | prognostic factors | comment |
|---|---|---|---|---|---|---|---|---|---|
Shepherd et al., 1997 [4] | 29 ("high-grade astrocy-toma") | 5 (daily) | 20–50 | 24 (3–93) | -- | 10.7 months | 6% | initial low-grade histology associated with longer survival | 36% steroid dependent toxicity (increased risk >40 Gy) |
Glass et al., 1997 [6] | 20 (7 grade III, 13 grade IV) | 3.5–6 (twice / week) | 35–42 | 14 (2–122) | cisplatin 40 mg/m2 weekly | 12.7 months | 15% pre-dominant necrosis on re-operation | -- | 40% treated within 10 weeks of first RT series for ("potential") progression |
Hudes et al., 1999 [5] | 19 (glio-blastoma) | 3–3.5 (daily) | 24–35 | 13 (1–48) | -- | 10.5 months | 0% | "minor response" on imaging associated with ≥30 Gy and ≤20 ml | recurrent or persistent tumors treated, median interval between completion of RT and HFSRT only 3.1 months |
Lederman et al., 2000 [7] | 88 (glio-blastoma) | 4–9 (weekly) | 18–36 | 32.7 (2–150) | paclitaxel 120 mg/m2 (median) weekly | 7 months | 8% necrosis only at re-operation | volume ≥30 ml associated with longer survival | median time from diagnosis to HFSRT only 6.5 months |
Voynov et al., 2002 [8] | 10 (5 WHO grade III, 5 grade IV) | 5 | 30 | 34.7 | -- | 10.1 months | ? | -- | stereotactic intensity-modulated radiotherapy (IMRT) used |
present series | 19 (5 WHO grade III, 14 grade IV) | 4–10 (daily) | 20–30 | 15 (4–70) | -- | 9.3 months | 0% | WHO grade IV and <30 Gy associated with short survival | median interval post-OP RT to HFSRT 19 months |