Page 18 - IJCS Journal Vol.1.cdr

theijcs.com The IJCS / Vol 1 / Issue 1

TO STUDY THE ROLE OF REIRRADIATION IN RECURRENT GLIOBLASTOMA

Vikas Roshan; American Oncology Institute Jammu, India

INTRODUCTION: Clinical Outcomes after primary treatment in case of recurrent glioblastoma (GBM) are dismal. One

of the treatment options left after brain tumors recurrence is reirradiation.

AIM: To study the feasibility of reirradiation in recurrent glioblastoma.

MATERIAL AND METHODS: We have analyzed 11 patients at our institute that came with progression after primary
treatment of GBM. Patients were treated with surgery followed by postoperative concurrent chemo radiotherapy and

then adjuvant temozolomide. All patients received 60Gy/30# with concurrent temozolomide. In adjuvant settings, four
patients (44%) received 12 cycles of TMZ, and seven (77%) patientsreceived six cycles of TMZ. All patients with
recurrent brain tumor underwent planning CT/MRI scan with Double shell positioning system.

Images are fused MONACO FOCAL SIM Version 5.11.01. Software. The residualvolume on T1 contrast and T2 flair on
MRI was contoured and transferred to primary CT scan for treatment planning. Median PTV Volume was 350 cc.
All patients were planned for 45Gy/25# to tumor and edema and 9Gy/5# to tumors only. RESULTS: Median time of

presentation to hospital after primary treatment was 7 months. The patients who present within one year of primary
treatment with recurrence are two (22%) in no and started on dose dense temozolamide 14 days on, and one week off
regimen, Five (55%) of patients underwent second surgery and rest four patients (44%) refused surgery and were

planned for radiotherapy with concurrent temozolamide.
All patient completed treatment. All patients were given steroids during radiation, but three patients (33%) needed
increased dose of steroids. Median progression-free survival noted was 4.2 months.

CONCLUSION: Re-irradiation was a well-tolerated procedure with no grade 3-4 toxicities even in recurrent settings.
Favorable outcomes of re-irradiation after primary failure in patients with recurrent GBM suggest its role as a treatment

option for small volume recurrences.

Corresponding Author
Vikas Roshan;
American Oncology Institute Jammu, India

The Integrated Indian Journal of Cancer Sciences