EP-1251 Focal Hypofractionated Stereotactic Radiation Therapy for Brain Metastases

Purpose or ObjectiveOptimal management for recurrent glioblastoma (GBM) has not been established.Many therapies have been assessed with limited results and without significant increase in progression-free survival (PFS), or overall survival (OS).The object of this retrospective analysis was to evaluate the impact on OS with different salvage therapies, including systemic therapy, or re-irradiation plus systemic therapy or supportive care in patients affected by recurrent GBM to generate new hypotheses for future trials. Material and MethodsPatients (pts) affected by GBM's recurrence and treated with according to EORTC 26981-22981-NCIC trial, were included.Those who died less a month after progression or with a poor performance status were excluded.Patients were subdivided into 3 groups: reirradiation plus chemotherapy (group A), chemotherapy alone (group B), supportive care (group C).Overall Survival was estimated using the Kaplan-Meier method and compared between three groups. ResultsThe analysis included 217 pts with GBM who developed relapse from January 2009 to May 2016.Among them, 153 patients were evaluable for this analysis; 64 patients were excluded because they died less than one month after progression or for a poor performance status.Sixty-nine out of 153 patients (45%) belonged to Group C, 63 (41%) to group B, and 21 (14%) to group A. Median follow-up was 48 months in all patients.Median survival time from diagnosis was 18 months for the entire cohort: 14 months for patients of Group C, 28 months for group B, and 30 months for those of group A. The kind of treatment at recurrence time proved to significantly impact on OS (p=0.0001). ConclusionPatients who did not receive any treatment had poorer survival than those who received chemotherapy alone or in combination with radiotherapy.Latter had a significantly better survival then chemotherapy group.Further investigations are needed to define the optimal choice of therapy, and in particular the role of reirradiation and systemic treatment in patients with recurrent GBM.