复发性胶质母细胞瘤的放射手术或立体定向分割放疗再照射联合瑞非尼。

IF 2.7 3区 医学 Q3 ONCOLOGY Strahlentherapie und Onkologie Pub Date : 2024-09-01 Epub Date: 2023-11-21 DOI:10.1007/s00066-023-02172-9
Fabiana Gregucci, Fiorella Cristina Di Guglielmo, Alessia Surgo, Roberta Carbonara, Letizia Laera, Maria Paola Ciliberti, Maria Annunziata Gentile, Roberto Calbi, Morena Caliandro, Nicola Sasso, Valerio Davi', Ilaria Bonaparte, Vincenzo Fanelli, David Giraldi, Romina Tortora, Valeria Internò, Francesco Giuliani, Giammarco Surico, Francesco Signorelli, Giuseppe Lombardi, Alba Fiorentino
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引用次数: 0

摘要

目的:复发性胶质母细胞瘤(GBM)的标准治疗方法尚未建立。在这种情况下,本研究的目的是评估放射手术或分割立体定向放疗(SRS/FSRT)联合瑞非尼的再照射(re-RT)的安全性和有效性。方法:组织学或影像学诊断为复发性GBM并接受SRS/FSRT和瑞非尼作为二线全身治疗的患者纳入分析。结果:2020年1月至2022年12月,对21例患者进行评估。从初始/辅助放疗到疾病复发的中位时间为8个月(范围5-20)。重新放射治疗的中位剂量为24 Gy(范围18-36 Gy), 5个部分的中位剂量(范围1-6)。瑞非尼治疗的中位持续时间为12周(范围3-26周)。在开始瑞非尼治疗前或化疗期间停止瑞非尼治疗的一周内给予Re-RT。复发后的中位和6个月总生存期(OS)分别为8.4个月(95%可信区间[CI] 6.9-12.7个月)和75% (95% CI 50.9-89.1%)。复发后的中位无进展生存期(PFS)为6个月(95% CI 3.7-8.5个月)。最常见的副作用是虚弱,10例患者(8例2级,2例3级),手足皮肤反应(2例3级,3例2级)。不良事件导致2例永久停药,5/21例(23.8%)患者减量。1例患者在再干预和瑞非尼治疗期间出现手术伤口裂开,另1例患者报告肠穿孔,需要住院治疗。结论:对于复发性GBM, SRT/FSRT联合瑞非尼是一种安全的治疗方法。前瞻性试验是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Reirradiation with radiosurgery or stereotactic fractionated radiotherapy in association with regorafenib in recurrent glioblastoma.

Purpose: No standard treatment has yet been established for recurrent glioblastoma (GBM). In this context, the aim of the current study was to evaluate safety and efficacy of reirradiation (re-RT) by radiosurgery or fractionated stereotactic radiotherapy (SRS/FSRT) in association with regorafenib.

Methods: Patients with a histological or radiological diagnosis of recurrent GBM who received re-RT by SRS/FSRT and regorafenib as second-line systemic therapy were included in the analysis.

Results: From January 2020 to December 2022, 21 patients were evaluated. The median time between primary/adjuvant RT and disease recurrence was 8 months (range 5-20). Median re-RT dose was 24 Gy (range 18-36 Gy) for a median number of 5 fractions (range 1-6). Median regorafenib treatment duration was 12 weeks (range 3-26). Re-RT was administered before starting regorafenib or in the week off regorafenib during the course of chemotherapy. The median and the 6‑month overall survival (OS) from recurrence were 8.4 months (95% confidence interval [CI] 6.9-12.7 months) and 75% (95% CI 50.9-89.1%), respectively. The median progression-free survival (PFS) from recurrence was 6 months (95% CI 3.7-8.5 months). The most frequent side effects were asthenia that occurred in 10 patients (8 cases of grade 2 and 2 cases of grade 3), and hand-foot skin reaction (2 patients grade 3, 3 patients grade 2). Adverse events led to permanent regorafenib discontinuation in 2 cases, while in 5/21 cases (23.8%), a dose reduction was administered. One patient experienced dehiscence of the surgical wound after reintervention and during regorafenib treatment, while another patient reported intestinal perforation that required hospitalization.

Conclusion: For recurrent GBM, re-RT with SRT/FSRT plus regorafenib is a safe treatment. Prospective trials are necessary.

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来源期刊
CiteScore
5.70
自引率
12.90%
发文量
141
审稿时长
3-8 weeks
期刊介绍: Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.
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