Hypofractionated Stereotactic Radiotherapy in Recurrent Glioblastoma Multiforme

Prospective Randomized Phase II Trial of Hypofractionated Stereotactic Radiotherapy in Recurrent Glioblastoma Multiforme

Glioblastoma multiforme (GBM) is the most common primary brain tumor in adults. The treatment comprises maximal safe resection followed by radiotherapy and chemotherapy. Despite appropriate management, 90% of the patients will develop relapse or progression. After progression, the median survival is 5.2 months (Stupp, 2009).

The treatment of GBM relapse remains investigational. Reirradiation is an option in selected cases.

The objective of this study is to compare 2 schemes of stereotactic hypofractionated radiotherapy in the management of recurrent GBM.

Inclusion Criteria:

• 18 years of age or older
• KPS equal or greater than 60
• Anatomopathological confirmation of GBM
• Previous RT with therapeutic doses
• At least 5 months from the end of RT course
• Not a candidate to surgical resection
• Patients with partial resection after resection of recurrent GBM will be allowed
• Patients with local progression after resection of recurrent GBM will be allowed
• Lesion with a maximal 150cc volume, as defined by enhancing portion in contrast enhanced MRI
• Hemoglobin levels (Hb) equal or greater than 10ng/dl. Blood transfusions to correct the Hb will be allowed.

Exclusion Criteria:

• Important comorbidities
• Concomitant chemotherapy
• Contraindication to MRI
• Brainstem glioma