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Purpose <p>To assess the feasibility, safety, and clinical outcomes of salvage reirradiation, using intensity-modulated radiotherapy (IMRT) with a total dose of 30&#xa0;Gy and cumulative equivalent dose in 2&#xa0;Gy fractions (EQD2) limited to ≤ 96&#xa0;Gy in patients with recurrent high-grade gliomas.</p> Materials and methods <p>This retrospective study included 24 patients with recurrent high-grade gliomas who underwent IMRT-based reirradiation between 2014 and 2021. Treatment planning was performed using computed tomography-magnetic resonance imaging fusion images, and radiotherapy was delivered via IMRT or volumetric-modulated arc therapy. No concurrent chemotherapy was administered, and the cumulative EQD2 to the brain was restricted to 96&#xa0;Gy.</p> Results <p>The median follow-up was 8&#xa0;months (range, 1–31&#xa0;months). The median overall survival was 8&#xa0;months, with 1- and 2-year overall survival rates of 29% and 4%, respectively. No grade ≥ 2 toxicity or cases of radiation necrosis were observed. All patients completed the planned treatment course without interruption.</p> Conclusion <p>Salvage reirradiation using IMRT with an EQD2 limited to ≤ 96&#xa0;Gy was a feasible and well-tolerated treatment strategy for select patients with recurrent high-grade gliomas. This approach may offer a modest survival benefit with minimal toxicity and warrants further investigation in prospective trials.</p>

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Safety and efficacy of salvage reirradiation for recurrent high-grade gliomas: a retrospective analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月5日

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  • Miki Tsujii,
  • Yaichiro Hashimoto,
  • Yuka Kaizu,
  • Kenta Ohmatsu,
  • Sawa Kono,
  • Shigehiko Kuribayashi

摘要

Purpose

To assess the feasibility, safety, and clinical outcomes of salvage reirradiation, using intensity-modulated radiotherapy (IMRT) with a total dose of 30 Gy and cumulative equivalent dose in 2 Gy fractions (EQD2) limited to ≤ 96 Gy in patients with recurrent high-grade gliomas.

Materials and methods

This retrospective study included 24 patients with recurrent high-grade gliomas who underwent IMRT-based reirradiation between 2014 and 2021. Treatment planning was performed using computed tomography-magnetic resonance imaging fusion images, and radiotherapy was delivered via IMRT or volumetric-modulated arc therapy. No concurrent chemotherapy was administered, and the cumulative EQD2 to the brain was restricted to 96 Gy.

Results

The median follow-up was 8 months (range, 1–31 months). The median overall survival was 8 months, with 1- and 2-year overall survival rates of 29% and 4%, respectively. No grade ≥ 2 toxicity or cases of radiation necrosis were observed. All patients completed the planned treatment course without interruption.

Conclusion

Salvage reirradiation using IMRT with an EQD2 limited to ≤ 96 Gy was a feasible and well-tolerated treatment strategy for select patients with recurrent high-grade gliomas. This approach may offer a modest survival benefit with minimal toxicity and warrants further investigation in prospective trials.