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21-11-2023 | Regorafenib | Original Article

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

Authors: Fabiana Gregucci, M.D., 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

Published in: Strahlentherapie und Onkologie

Abstract

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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Title: Reirradiation with radiosurgery or stereotactic fractionated radiotherapy in association with regorafenib in recurrent glioblastoma
Authors: Fabiana Gregucci, M.D.
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
Publication date: 21-11-2023
Publisher: Springer Berlin Heidelberg
Keywords: Regorafenib
Radiotherapy
Glioblastoma
Glioblastoma
Glioblastoma
Glioma
Glioma
Glioma
Published in: Strahlentherapie und Onkologie
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-023-02172-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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