Validation of the prognostic Heidelberg re-irradiation score in an independent mono-institutional patient cohort
Niyazi M, Flieger M, Ganswindt U, Combs SE, Belka C (2014)
Publication Type: Journal article
Publication year: 2014
Journal
Book Volume: 9
Article Number: 128
Journal Issue: 1
Abstract
Purpose: Re-irradiation has been shown to be a valid option with proven efficacy for recurrent high-grade glioma patients. Overall, up to now it is unclear which patients might be optimal candidates for a second course of irradiation. A recently reported prognostic score developed by Combs et al. may guide treatment decisions and thus, our mono-institutional cohort served as validation set to test its relevance for clinical practice.Patients and methods: The prognostic score is built upon histology, age (< 50 vs. ≥ 50 years) and the time between initial radiotherapy and re-irradiation (≤ 12 vs. > 12 months). This score was initially introduced to distinguish patients with excellent (0 points), good (1 point), moderate (2 points) and poor (3-4 points) post-recurrence survival (PRS) after re-irradiation. Median prescribed radiation dose during re-treatment of recurrent malignant glioma was 36 Gy in 2 Gy single fractions. A substantial part of the patients was additionally treated with bevacizumab (10 mg/kg intravenously at d1 and d15 during re-irradiation).Results: 88 patients (initially 61 WHO IV, 20 WHO III, 7 WHO II) re-irradiated in a single institution were retrospectively analyzed. Median follow-up was 30 months and median PRS of the entire patient cohort 7 months. Seventy-one patients (80.7%) received bevacizumab. PRS was significantly increased in patients receiving bevacizumab (8 vs. 6 months, p = 0.027, log-rank test). KPS, age, MGMT methylation status, sex, WHO grade and the Heidelberg score showed no statistically significant influence on neither PR-PFS nor PRS.Conclusion: In our cohort which was mainly treated with bevacizumab the usefulness of the Heidelberg score could not be confirmed probably due to treatment heterogeneity; it can be speculated that larger multicentric data collections are needed to derive a more reliable score. © 2014 Niyazi et al.; licensee BioMed Central Ltd.
Involved external institutions
Ludwig-Maximilians-Universität (LMU)
Germany (DE)
Ruprecht-Karls-Universität Heidelberg
Germany (DE)
Germany (DE)
Ruprecht-Karls-Universität Heidelberg
Germany (DE)
How to cite
APA:
Niyazi, M., Flieger, M., Ganswindt, U., Combs, S.E., & Belka, C. (2014). Validation of the prognostic Heidelberg re-irradiation score in an independent mono-institutional patient cohort. Radiation Oncology, 9(1). https://doi.org/10.1186/1748-717X-9-128
MLA:
Niyazi, Maximilian, et al. "Validation of the prognostic Heidelberg re-irradiation score in an independent mono-institutional patient cohort." Radiation Oncology 9.1 (2014).
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