The aim of the present study was to evaluate the efficacy of re-irradiation (re-RT) in patients with advanced local relapses of glial tumours and to define the factors influencing the result of the hyper-fractionated external beam therapy on progression after primary management. We have analysed the data of 55 patients with brain tumours (GBM: 28) on progression, who were re-irradiated between January 2007 and December 2018. The mean volume of the recurrent tumour was 118 cm³, and the mean planning target volume (PTV) was 316 cm³, to which 32 Gy was delivered in 20 fractions at least 7.7 months after the first radiotherapy, using 3D conformal radiotherapy (CRT) or intensity modulated radiotherapy (IMRT). The median overall survival (mOS) from the re-RT was 8.4 months, and the 6-month and the 12-month OS rate was 64% and 31%, respectively. The most important factors by univariate analysis, which significantly improved the outcome of re-RT were the longer time interval between the diagnosis and second radiotherapy (p = 0.029), the lower histology grade (p = 0.034), volume of the recurrent tumour (p = 0.006) and Karnofsky performance status (KPS) (p = 0.009) at the re-irradiation. Our low fraction size re-irradiation ≥ 8 months after the first radiotherapy proved to be safe and beneficial for patients with large volume recurrent glial tumours.

本研究的目的是评估再次照射（re-RT）对晚期神经胶质瘤局部复发患者的疗效，并确定影响主要治疗后超分割外束治疗结果对进展的影响因素。我们分析了55例进展期的脑肿瘤患者（GBM：28）的数据，这些患者在2007年1月至2018年12月之间接受了再次放射治疗。复发肿瘤的平均体积为118 cm ³，平均计划目标体积为（ PTV）为316 cm ³首次放疗后至少7.7个月，使用3D适形放疗（CRT）或调强放疗（IMRT）在20个分数中向其中递送了32 Gy。re-RT的中位总体生存期（mOS）为8.4个月，而6个月和12个月OS率分别为64％和31％。单因素分析最能显着改善re-RT结果的最重要因素是诊断与第二次放疗之间的时间间隔更长（p  = 0.029），组织学等级较低（p  = 0.034），复发肿瘤的体积（p  = 0.006）和卡诺夫斯基绩效状态（KPS）（p = 0.009）。首次放疗后≥8个月的小剂量再照射被证明对大量复发性神经胶质瘤患者是安全且有益的。