a review of the role of re-irradiation in recurrent high-grade glioma (hgg)回顾re-irradiation在高档神经胶质瘤复发的作用(hgg).pdfVIP

Cancers 2011, 3, 4061-4089; doi:10.3390/cancers3044061 OPEN ACCESS cancers ISSN 2072-6694 /journal/cancers Review A Review of the Role of Re-Irradiation in Recurrent High-Grade Glioma (HGG) Maurizio Amichetti * and Dante Amelio ATreP, Agenzia Provinciale per la Protonterapia, via Perini 181, 38122 Trento, Italy; E-Mail: amelio@atrep.it * Author to whom correspondence should be addressed; E-Mail: amichett@atrep.it; Tel.: +39-0461-390409; Fax: +39-0461-397728. Received: 5 August 2011; in revised form: 8 October 2011 / Accepted: 21 October 2011 / Published: 28 October 2011 Abstract: Despite the use of more effective multimodal treatments in high-grade glioma (HGG), the outcome of patients affected by this disease is still dismal and recurrence is a very common event. Many therapeutic approaches, alone or combined (surgery, drugs, targeted agents, immunotherapy, radiotherapy, supportive therapy), are available in the clinical armamentarium so far. The attitude of physicians is increasingly interventionist, but recurrent HGG still remains a very difficult scenario to be treated. Radiotherapy with different re-irradiation techniques is increasingly proposed as a therapeutic option with interesting results, even though the resulting duration of response is usually quite short. Most lesions re-recur locally, with inadequate identification and targeting of viable tumor being the most important cause of failure. Progn