PURPOSE: To assess the contribution of Italian radiation oncologists in the current management of recurrent high-grade gliomas (HGG), focusing on a reirradiation (reRT) approach. METHODS: In 2015, the Reirradiation and the Central Nervous System Study Groups on behalf of the Italian Association of Radiation Oncology (AIRO) proposed a survey. All Italian radiation oncologists were individually invited to complete an online questionnaire regarding their clinical management of recurrent HGG, focusing on a reRT approach. RESULTS: A total of 37 of 210 questionnaires were returned (18% of all centers): 16 (43%) from nonacademic hospitals, 14 (38%) from academic hospitals, 5 (13%) from private institutions, and 2 (6%) from hadron therapy centers. The majority of responding centers (59%) treated ≤5 cases per year. Performance status at the time of recurrence, along with a target diameter <5 cm and an interval from primary radiation ≥6 months, were the prevalent predictive factors considered for reRT. Sixty percent of reirradiated patients had already received a salvage therapy, either chemotherapy (40%) or reoperation (20%). The most common approach for reRT was fractionated stereotactic radiotherapy to a mean (photon) dose of 41.6 Gy. CONCLUSIONS: Although there were wide variations in the clinical practice of reRT across the 37 centers, the core activities were reasonably consistent. These findings provide a basis for encouraging a national collaborative study to develop, implement, and monitor the use of reRT in this challenging clinical setting.
Furlan, C., Arcangeli, S., Avanzo, M., Mirri, M. A., Munoz, F., Giudici, S., Perrone, A., Amelio, D., Tomio, L., Draghini, L., Deli, A. M., Pavanato, G., Giugliano, F. M., Pontoriero, A., Ciammella, P., Navarria, P., Iannalfi, A., Buglione, M., Guida, C., Cammelli, S., Iorio, V., Cardinali, M., Genovesi, D., Barsacchi, L., Balducci, M., Bagnoli, R., Berti, F., Montesi, G., Pasqualetti, F., Bonome, P., Santoni, R., Doino, D., Schirru, P., Pinzi, V., Borzillo, V., Ferrarese, F., Ferro, M., De Cicco, L., Krengli, M., Scoccianti, S., Donato, V., Policies for reirradiation of recurrent high-grade gliomas: a survey among Italian radiation oncologists, <<TUMORI>>, 2017; 2017 (mar): 0-0. [doi:10.5301/tj.5000615] [http://hdl.handle.net/10807/112735]
Policies for reirradiation of recurrent high-grade gliomas: a survey among Italian radiation oncologists
Arcangeli, Stefano;Mirri, Maria Alessandra;Balducci, Mario;Ferro, Marica;
2017
Abstract
PURPOSE: To assess the contribution of Italian radiation oncologists in the current management of recurrent high-grade gliomas (HGG), focusing on a reirradiation (reRT) approach. METHODS: In 2015, the Reirradiation and the Central Nervous System Study Groups on behalf of the Italian Association of Radiation Oncology (AIRO) proposed a survey. All Italian radiation oncologists were individually invited to complete an online questionnaire regarding their clinical management of recurrent HGG, focusing on a reRT approach. RESULTS: A total of 37 of 210 questionnaires were returned (18% of all centers): 16 (43%) from nonacademic hospitals, 14 (38%) from academic hospitals, 5 (13%) from private institutions, and 2 (6%) from hadron therapy centers. The majority of responding centers (59%) treated ≤5 cases per year. Performance status at the time of recurrence, along with a target diameter <5 cm and an interval from primary radiation ≥6 months, were the prevalent predictive factors considered for reRT. Sixty percent of reirradiated patients had already received a salvage therapy, either chemotherapy (40%) or reoperation (20%). The most common approach for reRT was fractionated stereotactic radiotherapy to a mean (photon) dose of 41.6 Gy. CONCLUSIONS: Although there were wide variations in the clinical practice of reRT across the 37 centers, the core activities were reasonably consistent. These findings provide a basis for encouraging a national collaborative study to develop, implement, and monitor the use of reRT in this challenging clinical setting.
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