Fractionated Stereotactic Radiotherapy for Glioblastoma recurrence

• Hypofractionated Stereotactic Re-irradiation and Anti-PDL1 Durvalumab Combination in Recurrent Glioblastoma: STERIMGLI Phase I Results
• Fractionated stereotactic re-irradiation for recurrent glioblastoma: A systematic review and meta-analysis
• RADIOSURGICAL TREATMENT OF RECURRENT GLIOBLASTOMA AND PROGNOSTIC FACTORS AFFECTING TREATMENT OUTCOMES
• Patterns of Progression in Patients With Newly Diagnosed Glioblastoma Treated With 5-mm Margins in a Phase 1/2 Trial of 5-Fraction Stereotactic Radiosurgery With Concurrent and Adjuvant Temozolomide
• Impact of fractionated stereotactic radiotherapy on activity of daily living and performance status in progressive/recurrent glioblastoma: a retrospective study
• Radiosurgery and Stereotactic Brain Radiotherapy with Systemic Therapy in Recurrent High-Grade Gliomas: Is It Feasible? Therapeutic Strategies in Recurrent High-Grade Gliomas
• Updates in the Management of Recurrent Glioblastoma Multiforme
• Relapsing High-Grade Glioma from Peritumoral Zone: Critical Review of Radiotherapy Treatment Options

Demogeot et al. aimed to evaluate which factors lead to a lower Karnofsky performance status (KPS) score after Fractionated Stereotactic Radiotherapy.

They retrospectively collected data from patients treated with fSRT for recurrent GBM at the Institut de Cancérologie de Lorraine between October 2010 and November 2017 and analyzed which factors were associated with a lower KPS score.

59 patients received a dose of 25 Gy in 5 sessions spread over 5-7 days (80% isodose). The median time from the end of primary radiotherapy to the initiation of fSRT was 10.7 months. The median follow-up after fSRT initiation was 8.8 months. The incidence of KPS and activities of daily living (ADL) impairment in all patients were 51.9% and 37.8% respectively with an adverse impact of Planning target volume (PTV) size on KPS (HR = 1.57 [95% CI 1.19-2.08], p = 0.028). Only two patients showed early grade 3 toxicity and none showed grade 4 or late toxicity. The median Survival rate, median overall survival time after fSRT, median progression-free survival and institutionalization-free survival times were 25.8, 8.8, 3.9 and 7.7 months, respectively. Initial surgery was associated with better progression-free survival (Hazard ratio (HR) = 0.48 [95% CI 0.27-0.86], p = 0.013).

A larger Planning target volume should predicts lower KPS in the treatment of recurrent GBM using fSRT ¹⁾.