Expert consensus on re-irradiation for recurrent glioma

Area of Science:

• Neuro-oncology
• Radiation Oncology
• Clinical Decision-Making

Background:

• Recurrent glioma presents a significant challenge in neuro-oncology.
• Re-irradiation (re-RT) is a potential treatment option, but decision-making is complex.
• Limited high-quality prospective data exists to guide re-RT in recurrent glioma.

Observation:

• A survey of 13 radiation oncologists focused on re-RT considerations for recurrent glioma.
• Respondents evaluated the relevance of various factors and made treatment decisions for clinical scenarios.
• Key factors influencing re-RT decisions included recurrent tumor volume, time since prior radiation, organ-at-risk dose, and patient performance status.

Findings:

• A majority of experienced radiation oncologists rated recurrent tumor volume, time since prior radiation, organ-at-risk dose, and patient performance status as highly relevant for offering re-RT.
• These factors were considered extremely or very relevant by 85%, 92%, 77%, and 69% of responders, respectively.
• Despite consensus on key factors, the practice of re-RT remains heterogeneous among experts.

Implications:

• The findings highlight critical factors that radiation oncologists use when considering re-irradiation for recurrent glioma.
• The heterogeneity in practice underscores the need for more robust clinical trial data.
• This survey provides practical insights and case examples that can help inform and support clinical decisions for re-RT in recurrent glioma.