Reirradiation vs. Systemic Therapy vs. Combination Therapy for Recurrent High-Grade Glioma: A Meta-Analysis of Survival and Toxicity.

Combination therapy may improve OS and PFS with acceptable toxicity in select patients with rHGG. Further RCTs comparing systemic therapy to combination therapy, particularly with bevacizumab-based systemic therapy, are needed. The limitations of previous RCTs must be addressed; namely inadequate accrual of appropriate patients, and exclusion of FLAIR abnormalities from target delineation.