Investigating the Effect of Reirradiation or Systemic Therapy in Patients With Glioblastoma After Tumor Progression: A Secondary Analysis of NRG Oncology/Radiation Therapy Oncology Group Trial 0525

Shi, Wenyin; Bryan, Molly Scannell; Gilbert, Mark R.; Mehta, Minesh P.; Blumenthal, Deborah T.; Brown, Paul D.; Valeinis, Egils; Hopkins, Kirsten; Souhami, Luís; Andrews, David W.; Tzuk-Shina, Tzahala; Howard, Steve; Youssef, Emad; Lessard, N.; Dignam, James J.; Werner‐Wasik, Maria

doi:10.1016/j.ijrobp.2017.08.038

Cited by 58 publications

(36 citation statements)

References 22 publications

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“…There are only very few prospective reports on the efficacy of re-RT. Shi and colleagues recently published the late results from RTOG 0525 trial [37]. Patients received BSC only had an mOS of 4.8 months versus the groups treated with re-RT only, chemotherapy only or radiochemotherapy, 8.2, 10.5, 11.3 months, respectively [37].…”

Section: Discussionmentioning

confidence: 99%

“…Shi and colleagues recently published the late results from RTOG 0525 trial [37]. Patients received BSC only had an mOS of 4.8 months versus the groups treated with re-RT only, chemotherapy only or radiochemotherapy, 8.2, 10.5, 11.3 months, respectively [37]. It should be noted that in this study OS was calculated from the first progression and not from the beginning of re-RT, as it is in our present study.…”

Section: Discussionmentioning

confidence: 99%

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Low Fraction Size Re-irradiation for Large Volume Recurrence of Glial Tumours

Dobi

Darázs

Fodor

et al. 2020

Pathol. Oncol. Res.

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The aim of the present study was to evaluate the efficacy of re-irradiation (re-RT) in patients with advanced local relapses of glial tumours and to define the factors influencing the result of the hyper-fractionated external beam therapy on progression after primary management. We have analysed the data of 55 patients with brain tumours (GBM: 28) on progression, who were reirradiated between January 2007 and December 2018. The mean volume of the recurrent tumour was 118 cm 3 , and the mean planning target volume (PTV) was 316 cm 3 , to which 32 Gy was delivered in 20 fractions at least 7.7 months after the first radiotherapy, using 3D conformal radiotherapy (CRT) or intensity modulated radiotherapy (IMRT). The median overall survival (mOS) from the re-RT was 8.4 months, and the 6-month and the 12-month OS rate was 64% and 31%, respectively. The most important factors by univariate analysis, which significantly improved the outcome of re-RT were the longer time interval between the diagnosis and second radiotherapy (p = 0.029), the lower histology grade (p = 0.034), volume of the recurrent tumour (p = 0.006) and Karnofsky performance status (KPS) (p = 0.009) at the re-irradiation. Our low fraction size re-irradiation ≥ 8 months after the first radiotherapy proved to be safe and beneficial for patients with large volume recurrent glial tumours.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Low Fraction Size Re-irradiation for Large Volume Recurrence of Glial Tumours

Dobi

Darázs

Fodor

et al. 2020

Pathol. Oncol. Res.

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“…Role of re-RT for progressed GBL can be reflected in an analysis of patients enrolled in the RTOG 0525 trial. After progression, the median overall survival (OS) after re-RT was better compared to supportive care only (8.2–12.2 months vs. 4.8 months) [6].…”

Section: Re-rt Alonementioning

confidence: 99%

“…The radionecrosis chance was <5% [27]. Another study has found an improvement of median OS by combining re-RT with unspecified chemotherapeutic agents (12.2 vs. 8.2 month) [6].…”

Section: Re-rt With Combined Chemotherapymentioning

confidence: 99%

Appraisal of re-irradiation for the recurrent glioblastoma in the era of MGMT promotor methylation

Kim

2019

Radiat Oncol J

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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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“…Glioblastoma multiforme (GBM) is the most prevalent and aggressive form of primary brain tumors in adults, the current standard of care for which includes surgical recession of tumor followed by radio-and chemotherapies [1][2][3]. However, the extensive infiltrative nature of GBM tumors makes complete surgical recession difficult.…”

Section: Introductionmentioning

confidence: 99%

Salinomycin-Loaded Iron Oxide Nanoparticles for Glioblastoma Therapy

et al. 2020

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Salinomycin is an antibiotic introduced recently as a new and effective anticancer drug. In this study, magnetic iron oxide nanoparticles (IONPs) were utilized as a drug carrier for salinomycin for potential use in glioblastoma (GBM) chemotherapy. The biocompatible polyethylenimine (PEI)-polyethylene glycol (PEG)-IONPs (PEI-PEG-IONPs) exhibited an efficient uptake in both mouse brain-derived microvessel endothelial (bEnd.3) and human U251 GBM cell lines. The salinomycin (Sali)-loaded PEI-PEG-IONPs (Sali-PEI-PEG-IONPs) released salinomycin over 4 days, with an initial release of 44% ± 3% that increased to 66% ± 5% in acidic pH. The Sali-IONPs inhibited U251 cell proliferation and decreased their viability (by approximately 70% within 48 h), and the nanoparticles were found to be effective in reactive oxygen species-mediated GBM cell death. Gene studies revealed significant activation of caspases in U251 cells upon treatment with Sali-IONPs. Furthermore, the upregulation of tumor suppressors (i.e., p53, Rbl2, Gas5) was observed, while TopII, Ku70, CyclinD1, and Wnt1 were concomitantly downregulated. When examined in an in vitro blood–brain barrier (BBB)-GBM co-culture model, Sali-IONPs had limited penetration (1.0% ± 0.08%) through the bEnd.3 monolayer and resulted in 60% viability of U251 cells. However, hyperosmotic disruption coupled with an applied external magnetic field significantly enhanced the permeability of Sali-IONPs across bEnd.3 monolayers (3.2% ± 0.1%) and reduced the viability of U251 cells to 38%. These findings suggest that Sali-IONPs combined with penetration enhancers, such as hyperosmotic mannitol and external magnetic fields, can potentially provide effective and site-specific magnetic targeting for GBM chemotherapy.

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Investigating the Effect of Reirradiation or Systemic Therapy in Patients With Glioblastoma After Tumor Progression: A Secondary Analysis of NRG Oncology/Radiation Therapy Oncology Group Trial 0525

Cited by 58 publications

References 22 publications

Low Fraction Size Re-irradiation for Large Volume Recurrence of Glial Tumours

Low Fraction Size Re-irradiation for Large Volume Recurrence of Glial Tumours

Appraisal of re-irradiation for the recurrent glioblastoma in the era of MGMT promotor methylation

Salinomycin-Loaded Iron Oxide Nanoparticles for Glioblastoma Therapy

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