Reirradiation of recurrent WHO grade III astrocytomas using fractionated stereotactic radiotherapy (FSRT)

Purpose: To assess the effect of reirradiation in recurrent WHO grade III astrocytomas. Patients and Methods: From January 1995 to July 2003, 40 patients with grade III gliomas were treated with fractionated stereotactic reirradiation at the time point of recurrence. Median size of planning target volume for reirradiation was 56.2 ml (range 25.1-296.2 ml). A median target total dose of 36 Gy (range 20-57.6 Gy) was applied using a median fractionation of 5 x 2 Gy/week with a 6-MeV Linear accelerator. Results: Radiotherapy was well tolerated by all patients. No toxicities > CTC grade 2 developed. Median overall survival calculated from the time point of primary diagnosis was 48 months (range 7-180 months). The 5- and 10-year overall survival rates were 49.5% and 24.7%, respectively. From the time point of reirradiation, median survival was 16 months (range 1-98 months). Median progression-free survival from the time point of reirradiation was 8 months (range 1-72 months). No prognosticators for survival or progression-free survival after reirradiation could be identified. Conclusion: Fractionated stereotactic radiotherapy is well tolerated and effective in patients with recurrent grade III astrocytomas.