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01-04-2014 | Clinical Study

Re-irradiation and bevacizumab in recurrent high-grade glioma: an effective treatment option

Authors: Maya Flieger, Ute Ganswindt, Silke Birgit Schwarz, Friedrich-Wilhelm Kreth, Jörg-Christian Tonn, Christian la Fougère, Lorenz Ertl, Jennifer Linn, Ulrich Herrlinger, Claus Belka, Maximilian Niyazi

Published in: Journal of Neuro-Oncology | Issue 2/2014

Abstract

Re-irradiation has been shown to be a meaningful option for recurrent high-grade glioma (HGG) patients. Furthermore, bevacizumab exerts certain activity in combination with chemotherapy/as monotherapy and was safely tested in combination with radiotherapy in several previous studies. To our knowledge, this is the largest cohort of patients treated with both re-irradiation and bevacizumab to date. After receiving standard radiotherapy (with or without TMZ) patients with recurrent HGG were treated with bevacizumab (10 mg/kg intravenously at d1 and d15) during re-irradiation. Median prescribed radiation dose during re-treatment was 36 Gy, conventionally fractionated. Datasets of 71 re-irradiated patients were retrospectively analyzed. Patients either received bevacizumab (N = 57) or not (N = 14; other substances (N = 4) and sole radiation (N = 10)). In patients receiving bevacizumab, both post-recurrence survival (PRS) (median 8.6 vs. 5.7 months; p = 0.003, log-rank test) and post-recurrence progression-free survival (PR-PFS, 5.6 vs. 2.5 months; p = 0.005, log-rank test; PFS-6 42.1 % for the bevacizumab group) were significantly increased which was confirmed by multivariate analysis. KPS, re-surgery, MGMT methylation status, sex, WHO grade, tumor volume and age were no significant predictors for neither PR-PFS nor PRS (univariate analysis). Re-irradiation with bevacizumab remains a feasible and highly effective treatment schedule. Studies on further salvage strategies and timing of sequential treatment options versus observation are warranted.

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Title: Re-irradiation and bevacizumab in recurrent high-grade glioma: an effective treatment option
Authors: Maya Flieger
Ute Ganswindt
Silke Birgit Schwarz
Friedrich-Wilhelm Kreth
Jörg-Christian Tonn
Christian la Fougère
Lorenz Ertl
Jennifer Linn
Ulrich Herrlinger
Claus Belka
Maximilian Niyazi
Publication date: 01-04-2014
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2014
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-014-1394-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Re-irradiation and bevacizumab in recurrent high-grade glioma: an effective treatment option

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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