Salvage therapy for recurrent glioblastoma multiforme: a multimodal approach combining fluorescence-guided resurgery, interstitial irradiation, and chemotherapy

Archavlis, Eleftherios; Tselis, Nikolaos; Birn, Gerhard; Ulrich, P.; Zamboglou, Nikolaos

doi:10.1179/1743132814y.0000000398

Cited by 25 publications

(20 citation statements)

References 33 publications

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“…Focusing solely on patients with recurrent HGGs (34 total, 21 grade IV tumors), Nabavi et al confirmed those findings both in pooled HGGs (median OS, 7.9 months) and in grade IV gliomas only (median OS, 7.4 months); the OS for grade III gliomas was slightly higher (9.9 months). Archavlis and colleagues also prospectively assessed recurrent grade IV gliomas that were deemed operable (17 patients), although those authors compared high‐dose‐rate brachytherapy plus dense‐dose temozolomide (ddTMZ) versus ddTMZ alone as postoperative adjuvant strategies . Progression was defined as an increase in volume by >25%.…”

Section: Resultsmentioning

confidence: 99%

“…Archavlis and colleagues also prospectively assessed recurrent grade IV gliomas that were deemed operable (17 patients), although those authors compared high-dose-rate brachytherapy plus dense-dose temozolomide (ddTMZ) versus ddTMZ alone as postoperative adjuvant strategies. 49 Progression was defined as an increase in volume by >25%. A statistically significant increase in PFS (mean, 7.0 vs 3.6 months with and without brachytherapy, respectively) and OS (median, 8.0 vs 5.0 months, respectively) was noted.…”

Section: Survival In Generalmentioning

confidence: 99%

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The role of 5‐aminolevulinic acid in enhancing surgery for high‐grade glioma, its current boundaries, and future perspectives: A systematic review

Mansouri

Mansouri²,

Hachem

et al. 2016

Cancer

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5-Aminolevulinic acid (5-ALA) has been approved as an intraoperative adjunct in glioma surgery in Europe, but not North America. A systematic review was conducted to assess the evidence regarding 5-ALA as a surgical adjunct. The MEDLINE, EMBASE, and CEN-TRAL databases were searched, using terms relevant to "5-ALA" and "high-grade gliomas." Included studies were based on adults aged 18 years who underwent surgical resection/biopsy. No language or date limitations were used. Forty-three studies (1830 patients) were identified. Thirty-six were coordinated by European countries, 2 were in the United States, and none were in Canada. One was randomized, 28 were prospective, and 14 were retrospective. Twenty-six studies assessed the utility of 5-ALA as a diagnostic tool, 24 assessed its influence on the extent of resection (EOR), 9 assessed survival, and 22 reported adverse events. 5-ALA had high sensitivity and positive predictive value, whereas its specificity increased with additional adjuncts. The EOR increased with 5-ALA, but only progression-free survival was significantly influenced. Reporting of adverse events was not systematic. The use of 5-ALA improved tumor visualization and thus enabled a greater EOR and perhaps increased survival. However, additional adjuncts may be necessary for maximizing the specificity of resection and patient safety. Additional parameters, such as patient quality of life and health economic analyses, would be informative. Thus, additional systematic collection of prospective evidence may be necessary for the global incorporation of this potentially valuable surgical adjunct into routine practice. Cancer 2016;122:2469-78.

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Section: Resultsmentioning

confidence: 99%

Section: Survival In Generalmentioning

confidence: 99%

The role of 5‐aminolevulinic acid in enhancing surgery for high‐grade glioma, its current boundaries, and future perspectives: A systematic review

Mansouri

Mansouri²,

Hachem

et al. 2016

Cancer

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“…Another drawback of the study that undermines reliability is the small number of patients included. Large number of patients could be adopted in a multicenter study which we are planning in the near future [44][45][46][47][48].…”

Section: Discussionmentioning

confidence: 99%

Combined Salvage Therapies for Recurrent Glioblastoma Multiforme: Treatment Options in Multifocal and Multicentric Patterns of Recurrence

Archavlis¹

2017

JCPCR

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“…In another study, BT treatment combined with carmustine wafers for the treatment of recurrent GBM resulted in the longest survival time of 69 weeks; however, the rate of severe toxicity was 35.3% ( 18 ). Despite a severe toxicity rate of 35% in 17 patients, Archavlis et al ( 61 ) reported only a single case of radionecrosis in a patient with a relatively large tumor volume of 38.1 ml ( 61 ). The study attributed the one case of radionecrosis to the requirement for better fixation of the radioactive seeds, which would limit the radioisotopes from migrating.…”

Section: Treatment Alternatives For Re-irradiationmentioning

confidence: 99%

Re-irradiation alternatives for recurrent high-grade glioma

Dong

Guan

et al. 2016

Oncology Letters

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Despite advances in the fields of surgery, chemotherapy and radiotherapy, the prognosis for high-grade glioma (HGG) remains unsatisfactory. The majority of HGG patients experience disease recurrence. To date, no standard treatments have been established for recurrent HGG. Repeat surgery and chemotherapy demonstrate moderate efficacy. As recurrent lesions are usually located within the previously irradiated field, a second course of irradiation was once considered controversial, as it was considered to exhibit unsatisfactory efficacy and radiation-related toxicities. However, an increasing number of studies have indicated that re-irradiation may present an efficacious treatment for recurrent HGG. Re-irradiation may be delivered via conventionally fractionated stereotactic radiotherapy, hypofractionated stereotactic radiation therapy, stereotactic radiosurgery and brachytherapy techniques. In the present review, the current literature regarding re-irradiation treatment for recurrent HGG is summarized with regard to survival outcome and side effects.

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Salvage therapy for recurrent glioblastoma multiforme: a multimodal approach combining fluorescence-guided resurgery, interstitial irradiation, and chemotherapy

Cited by 25 publications

References 33 publications

The role of 5‐aminolevulinic acid in enhancing surgery for high‐grade glioma, its current boundaries, and future perspectives: A systematic review

The role of 5‐aminolevulinic acid in enhancing surgery for high‐grade glioma, its current boundaries, and future perspectives: A systematic review

Combined Salvage Therapies for Recurrent Glioblastoma Multiforme: Treatment Options in Multifocal and Multicentric Patterns of Recurrence

Re-irradiation alternatives for recurrent high-grade glioma

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