What is your approach to brain reirradiation in the setting of recurrent/progressive gliomas?

If a WHO II glioma was treated with RT and recurs and is now a WHO III glioma would you retreat with radiation? What would be your target volumes/margins? What would be your doses? Would this be something you would treat with an SRS approach?

Answer from: Radiation Oncologist at Academic Institution

A lot of factors need to be considered prior to offering brain reRT in such a setting, most importantly- interval since the 1st course of RT, patient's ECOG and neurologic function, age, perceived life expectancy, size of the lesion, location of the lesion, WHO grade of glioma, patient's expectation...

Comments

Radiation Oncologist at Blanchard Valley Hospital
Well written response. Here is some prospective ev...

Radiation Oncologist at Icahn School of Medicine at Mount Sinai
Thank you, Dr. @Ankit Modh. This is a very importa...

Radiation Oncologist at Collom and Carney Clinic Assoc
Agree. Time from initial radiation, size of recurr...

Answer from: Radiation Oncologist at Academic Institution

I assume that grade II glioma was treated with 54 Gy, and there was sufficient time interval for re-irradiation, and other treatment options were also discussed. I use fractionated radiourgery: 8 Gy x 4 fractions to the contrast enhancing lesion (total 32 Gy) and 6 Gy x4 to the area of new flair abn...

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What is your approach to brain reirradiation in the setting of recurrent/progressive gliomas?

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