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Abstract
Introduction. Treatment of recurrent high-grade gliomas (HGGs) remains a complex clinical challenge due to the high recurrence rate and limited therapeutic options. Re-irradiation, particularly with proton therapy, represents a promising but understudied approach to improve survival in this patient population.
Objectives. To evaluate the safety and efficacy of re-irradiation with active scanning proton beam therapy for high-grade gliomas (HGGs) of the brain.
Materials and Methods. The study included 63 patients with recurrent HGGs (Grade III-IV) who underwent re-irradiation on the “Prometheus” proton therapy complex. The total dose (TD) was 50.7 Gy (equivalent to 56 Gy with consideration of the relative biological effectiveness (RBE)). Efficacy was assessed by overall survival (OS) and progression-free survival (PFS). Toxicity was evaluated based on the frequency of radiation-induced reactions.
Results. The median OS was 11.1 months, with a 1-year survival rate of 48.4 % and a 2-year survival rate of 21.5 %. The median PFS was 6 months, with a 1-year PFS rate of 40.4 % and a 2-year PFS rate of 19.3 %. The incidence of radionecrosis was 4.8 %. Analysis of prognostic factors revealed a significant impact of age, overall somatic status, and histological type of tumor on survival.
Conclusions. Re-irradiation with protons is a safe and effective treatment modality for recurrent HGGs, demonstrating acceptable toxicity and improved survival outcomes.
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