Preferred Imaging for Target Volume Delineation for Radiotherapy of Recurrent Glioblastoma: A Literature Review of the Available Evidence

Overview

Journal J Pers Med

Date 2024 May 25

PMID 38793120

Authors

Francesco Cuccia

Fatemeh Jafari

Salvatore DAlessandro

Giuseppe Carruba

Giuseppe Craparo

Giovanni Tringali

Livio Blasi

Giuseppe Ferrera

Affiliations

Soon will be listed here.

Abstract

Background: Recurrence in glioblastoma lacks a standardized treatment, prompting an exploration of re-irradiation's efficacy.

Methods: A comprehensive systematic review from January 2005 to May 2023 assessed the role of MRI sequences in recurrent glioblastoma re-irradiation. The search criteria, employing MeSH terms, targeted English-language, peer-reviewed articles. The inclusion criteria comprised both retrospective and prospective studies, excluding certain types and populations for specificity. The PICO methodology guided data extraction, and the statistical analysis employed Chi-squared tests via MedCalc v22.009.

Results: Out of the 355 identified studies, 81 met the criteria, involving 3280 patients across 65 retrospective and 16 prospective studies. The key findings indicate diverse treatment modalities, with linac-based photons predominating. The median age at re-irradiation was 54 years, and the median time interval between radiation courses was 15.5 months. Contrast-enhanced T1-weighted sequences were favored for target delineation, with PET-imaging used in fewer studies. Re-irradiation was generally well tolerated (median G3 adverse events: 3.5%). The clinical outcomes varied, with a median 1-year local control rate of 61% and a median overall survival of 11 months. No significant differences were noted in the G3 toxicity and clinical outcomes based on the MRI sequence preference or PET-based delineation.

Conclusions: In the setting of recurrent glioblastoma, contrast-enhanced T1-weighted sequences were preferred for target delineation, allowing clinicians to deliver a safe and effective therapeutic option; amino acid PET imaging may represent a useful device to discriminate radionecrosis from recurrent disease. Future investigations, including the ongoing GLIAA, NOA-10, ARO 2013/1 trial, will aim to refine approaches and standardize methodologies for improved outcomes in recurrent glioblastoma re-irradiation.

References

Oehlke O, Mix M, Graf E, Schimek-Jasch T, Nestle U, Gotz I . Amino-acid PET versus MRI guided re-irradiation in patients with recurrent glioblastoma multiforme (GLIAA) - protocol of a randomized phase II trial (NOA 10/ARO 2013-1). BMC Cancer. 2016; 16(1):769. PMC: 5052714. DOI: 10.1186/s12885-016-2806-z. View

Hasan S, Chen E, Lanciano R, Yang J, Hanlon A, Lamond J . Salvage Fractionated Stereotactic Radiotherapy with or without Chemotherapy and Immunotherapy for Recurrent Glioblastoma Multiforme: A Single Institution Experience. Front Oncol. 2015; 5:106. PMC: 4432688. DOI: 10.3389/fonc.2015.00106. View

Constine L, Konski A, Ekholm S, McDonald S, Rubin P . Adverse effects of brain irradiation correlated with MR and CT imaging. Int J Radiat Oncol Biol Phys. 1988; 15(2):319-30. DOI: 10.1016/s0360-3016(98)90011-6. View

Lautenschlaeger F, Dumke R, Schymalla M, Hauswald H, Carl B, Stein M . Comparison of carbon ion and photon reirradiation for recurrent glioblastoma. Strahlenther Onkol. 2021; 198(5):427-435. PMC: 9038837. DOI: 10.1007/s00066-021-01844-8. View

Scartoni D, Amelio D, Palumbo P, Giacomelli I, Amichetti M . Proton therapy re-irradiation preserves health-related quality of life in large recurrent glioblastoma. J Cancer Res Clin Oncol. 2020; 146(6):1615-1622. DOI: 10.1007/s00432-020-03187-w. View

van Linde M, Brahm C, de Witt Hamer P, Reijneveld J, Bruynzeel A, Vandertop W . Treatment outcome of patients with recurrent glioblastoma multiforme: a retrospective multicenter analysis. J Neurooncol. 2017; 135(1):183-192. PMC: 5658463. DOI: 10.1007/s11060-017-2564-z. View

Yazici G, Cengiz M, Ozyigit G, Eren G, Yildiz F, Akyol F . Hypofractionated stereotactic reirradiation for recurrent glioblastoma. J Neurooncol. 2014; 120(1):117-23. DOI: 10.1007/s11060-014-1524-0. View

She L, Su L, Liu C . Bevacizumab combined with re-irradiation in recurrent glioblastoma. Front Oncol. 2022; 12:961014. PMC: 9423039. DOI: 10.3389/fonc.2022.961014. View

Sirin S, Oysul K, Surenkok S, Sager O, Dincoglan F, Dirican B . Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: a single center experience. Vojnosanit Pregl. 2011; 68(11):961-6. DOI: 10.2298/vsp1111961s. View

10.

Guan Y, Li J, Gong X, Zhu H, Li C, Mei G . Safety and Efficacy of Hypofractionated Stereotactic Radiotherapy with Anlotinib Targeted Therapy for Glioblastoma at the First Recurrence: A Preliminary Report. Brain Sci. 2022; 12(4). PMC: 9032064. DOI: 10.3390/brainsci12040471. View

11.

Furuse M, Kawabata S, Wanibuchi M, Shiba H, Takeuchi K, Kondo N . Boron neutron capture therapy and add-on bevacizumab in patients with recurrent malignant glioma. Jpn J Clin Oncol. 2022; 52(5):433-440. DOI: 10.1093/jjco/hyac004. View

12.

Park K, Kano H, Iyer A, Liu X, Niranjan A, Flickinger J . Salvage gamma knife stereotactic radiosurgery followed by bevacizumab for recurrent glioblastoma multiforme: a case-control study. J Neurooncol. 2011; 107(2):323-33. DOI: 10.1007/s11060-011-0744-9. View

13.

Cabrera A, Cuneo K, Desjardins A, Sampson J, McSherry F, Herndon 2nd J . Concurrent stereotactic radiosurgery and bevacizumab in recurrent malignant gliomas: a prospective trial. Int J Radiat Oncol Biol Phys. 2013; 86(5):873-9. DOI: 10.1016/j.ijrobp.2013.04.029. View

14.

Bell J, Jin W, Goryawala M, Azzam G, Abramowitz M, Diwanji T . Delineation of recurrent glioblastoma by whole brain spectroscopic magnetic resonance imaging. Radiat Oncol. 2023; 18(1):37. PMC: 9948314. DOI: 10.1186/s13014-023-02219-2. View

15.

Elliott R, Parker E, Rush S, Kalhorn S, Moshel Y, Narayana A . Efficacy of gamma knife radiosurgery for small-volume recurrent malignant gliomas after initial radical resection. World Neurosurg. 2011; 76(1-2):128-40. DOI: 10.1016/j.wneu.2010.12.053. View

16.

Eberle F, Lautenschlager S, Engenhart-Cabillic R, Jensen A, Carl B, Stein M . Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma. Cancer Manag Res. 2020; 12:633-639. PMC: 6995286. DOI: 10.2147/CMAR.S217824. View

17.

Chapman C, Hara J, Molinaro A, Clarke J, Oberheim Bush N, Taylor J . Reirradiation of recurrent high-grade glioma and development of prognostic scores for progression and survival. Neurooncol Pract. 2019; 6(5):364-374. PMC: 6753361. DOI: 10.1093/nop/npz017. View

18.

Straube C, Elpula G, Gempt J, Gerhardt J, Bette S, Zimmer C . Re-irradiation after gross total resection of recurrent glioblastoma : Spatial pattern of recurrence and a review of the literature as a basis for target volume definition. Strahlenther Onkol. 2017; 193(11):897-909. DOI: 10.1007/s00066-017-1161-6. View

19.

Umeda K, Shibata H, Saida S, Hiramatsu H, Arakawa Y, Mizowaki T . Long-term efficacy of bevacizumab and irinotecan in recurrent pediatric glioblastoma. Pediatr Int. 2015; 57(1):169-71. DOI: 10.1111/ped.12414. View

20.

Minniti G, Armosini V, Salvati M, Lanzetta G, Caporello P, Mei M . Fractionated stereotactic reirradiation and concurrent temozolomide in patients with recurrent glioblastoma. J Neurooncol. 2010; 103(3):683-91. DOI: 10.1007/s11060-010-0446-8. View