Re-irradiation in High-grade Glioma: An Experience from A Series of Five Patients

The management of recurrences or residual lesions following radiation therapy for brain tumors poses a challenging clinical scenario, necessitating careful consideration for treatment strategies. There is no standard of care for patients with recurrent high-grade glioma. Treatment strategies include resection, re-irradiation, systemic agents, and intratumoral thermotherapy using magnetic iron-oxide nanoparticles (nanotherapy). A small percentage of patients can undergo repeat surgery and re-radiation is also a matter of concern due to anticipated toxicities. However, advancements in radiation technology have made people more willing to consider re-irradiation. In this study, we retrospectively analyzed patients who underwent re-irradiation for high-grade glioma. In total, five patients were included in the study. All five patients had anaplastic astrocytoma. All patients were considered for surgery, followed by radiation therapy during the initial treatment. Three patients had an average of 4 years of symptom-free survival, while the other two had symptoms ranging from moderate to severe. Three of the five patients died within 1 year of taking the re-radiation; however, two patients are still in follow-up.