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Appraisal of re-irradiation for the recurrent glioblastoma in the era of MGMT promotor methylation
Radiation Oncology Journal ; : 1-12, 2019.
Artículo en Inglés | WPRIM | ID: wpr-760995
ABSTRACT
Despite recent innovation in treatment techniques and subsequently improved outcomes, the majority of glioblastoma (GBL) have relapses, especially in locoregional areas. Local re-irradiation (re-RT) has been established as a feasible option for recurrent GBL of all ages with safety, tolerability, and effectiveness both in survival and quality of life regardless of fractionation schedule. To keep adverse effects under acceptable range, cumulative dose limit in equivalent dose at 2 Gy fractions by the linear-quadratic model at α/β = 2 for normal brain tissue (EQD2) with narrow margin should be observed and single/hypofractionated re-RT should be undertaken very carefully to recurrent tumor with large volume or adjacent to the brainstem. Promising outcome of re-operation (re-Op) plus re-RT (re-Op/RT) need to be validated and result from re-RT with temozolomide/bevacizumab (TMZ/BV) or new strategy is expected. Development of new-concept prognostic scoring or risk group is required to select patients properly and make use of predictive biomarkers such as O(6)-methylguanine-DNA methyltransferase (MGMT) promotor methylation that influence outcomes of re-RT, re-Op/RT, or re-RT with TMZ/BV.
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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Citas y Horarios / Calidad de Vida / Recurrencia / Encéfalo / Tronco Encefálico / Biomarcadores / Glioblastoma / O(6)-Metilguanina-ADN Metiltransferasa / Reirradiación / Metilación Tipo de estudio: Estudio pronóstico Límite: Humanos Idioma: Inglés Revista: Radiation Oncology Journal Año: 2019 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Citas y Horarios / Calidad de Vida / Recurrencia / Encéfalo / Tronco Encefálico / Biomarcadores / Glioblastoma / O(6)-Metilguanina-ADN Metiltransferasa / Reirradiación / Metilación Tipo de estudio: Estudio pronóstico Límite: Humanos Idioma: Inglés Revista: Radiation Oncology Journal Año: 2019 Tipo del documento: Artículo