Re-irradiation strategies in combination with bevacizumab for recurrent malignant glioma.
J Neurooncol
; 130(3): 591-599, 2016 12.
Article
en En
| MEDLINE
| ID: mdl-27599828
ABSTRACT
The place of bevacizumab (BEV) in salvage re-irradiation (Re-RT) settings of malignant glioma is poorly defined. In the current study risk/benefit profiles of two BEV-based Re-RT protocols were analyzed and compared with that of salvage BEV plus irinotecan (BEV/IRI). According to interdisciplinary tumor board recommendations, patients were assigned to one of three BEV-based treatment protocols (1) BEV/IRI, (2) Re-RT (36 Gy/18 fx) with concomitant BEV (Re-RT/BEV), and (3) Re-RT with concomitant/maintenance BEV (Re-RT/BEVâBEV). Prognostic factors were obtained from proportional hazards models. Adverse events were classified according to the NCI CTCAE, v4.0. 105 consecutive patients were enrolled from 08/2008 to 05/2014. Patients undergoing Re-RT experienced longer time intervals from initial diagnosis to BEV treatment (median 22.0 months vs. 13.7 months, p = 0.001); those assigned to Re-RT/BEVâBEV rated better on the performance scale (median KPSREC 90 vs. 70, p = 0.013). Post-recurrence survival after BEV-based treatment (PRS) was longest after Re-RT/BEVâBEV (median 13.1 months vs. 8 months, p = 0.006). PRS after Re-RT/BEV and BEV/IRI was similar. Multivariately, higher KPSREC and Re-RT/BEVâBEV were associated with longer PRS. Treatment toxicity did not differ among groups. Re-RT/BEVâBEV is safe, feasible and effective and deserves further prospective evaluation.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Encefálicas
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Bevacizumab
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Reirradiación
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Glioma
Tipo de estudio:
Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Neurooncol
Año:
2016
Tipo del documento:
Article
País de afiliación:
Alemania