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Patients with recurrent, high-grade glioma who were treated with hypofractionated stereotactic radiation therapy (H-SRT) experienced minimal side effects and a median survival of 11 months. These results were recently published in the Journal of Clinical Oncology.1

Brain CancerConnect 490

Gliomas are brain tumors that arise from glial cells (cells that provide a supportive function in the brain).

High-grade (malignant) gliomas refer to gliomas in which the cells appear moderately or very abnormal. Anaplastic astrocytoma (a grade III glioma) and glioblastoma (grade IV glioma) are types of high-grade gliomas.

Initial treatment of high-grade gliomas often involves surgery followed by radiation and chemotherapy. Although this approach has improved outcomes, many patients eventually experience cancer progression or recurrence. Treatment options for recurrent high-grade gliomas remain limited, and research in this area continues.

Stereotactic radiation therapy (SRT) involves the very precise delivery of a large dose of radiation to a tumor while sparing normal tissue. This approach is used to treat brain tumors and is also being explored in the treatment of other cancers. Hypofractionated SRT (H-SRT) delivers the same amount of radiation over a two-week period versus three to four weeks with standard SRT.

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In this study researchers evaluated the safety and efficacy of H-SRT alone as well as combined with surgery or chemotherapy in patients with recurrent high-grade glioma. From 1994 to 2008, 147 patients were treated with H-SRT, H-SRT and repeat surgery, or H-SRT and chemotherapy.

H-SRT was well tolerated with minimal side effects, and the median survival time was 11 months. The combination of surgery or chemotherapy with H-SRT did not improve survival time, but this was not a randomized trial. The researchers also reported that patients who recurred within six months from initial treatment also benefited from H-SRT.

The researchers concluded that H-SRT may provide a survival benefit with minimal side effects for patients with recurrent high-grade glioma. Prospective, randomized trials are warranted to confirm these findings and to determine the role of H-SRT in recurrent high-grade glioma.

Brain Cancer Newsletter 490


1 Fogh SE, Andrews DW, Glass J, et al. Hypofractionated Stereotactic Radiation Therapy: An Effective Therapy for Recurrent High-Grade Gliomas. Journal of Clinical Oncology [early online publication]. May 17, 2010.