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Báo cáo y học: "Multiple courses of stereotactic re-irradiation in recurrent oligodendroglioma: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Multiple courses of stereotactic re-irradiation in recurrent oligodendroglioma: a case report. | Fogh et al. Journal of Medical Case Reports 2011 5 183 http www.jmedicalcasereports.eom content 5 1 183 JOURNALOF medical case reports CASE REPORT Open Access Multiple courses of stereotactic re-irradiation in recurrent oligodendroglioma a case report Shannon Fogh1 Charles Glass2 David W Andrews3 and Maria Werner-Wasik2 Abstract Introduction High grade gliomas are an insidious disease associated with an extremely poor prognosis. The role of re-irradiation for recurrent gliomas is unclear but several retrospective studies have indicated mild toxicity and modest outcomes with this regimen. With subsequent progression it is unclear what options remain and more radiotherapy is rarely offered for fear of surpassing normal central nervous system tissue tolerance and causing significant side effects without significant benefit. Case presentation In this report we describe a 37-year-old Caucasian male initially diagnosed with a grade IV oligodendroglioma who received multiple courses of re-irradiation and experienced a survival of 10 years with minimal cognitive or neurologic deficits. Conclusion Significant toxicity with multiple courses of radiation does not always occur. Re-irradiation should be considered in a salvage setting. Introduction The standard of treatment of newly diagnosed high-grade gliomas is resection followed by post-resection radiation therapy given with concurrent and adjuvant Temozolomide 1 . Recurrence is extremely common with limited treatment options 2 . There are many approaches currently available for the salvage treatment of patients with recurrent high-grade gliomas following initial radiation therapy including resection re-irradiation or systemic agents but no standard of care exists. While practiced in some institutions the role of re-irradiation for treatment of recurrence of disease is not well defined. Reluctance to offer multiple courses of radiation stems from hesitation to exceed the radiation dose tolerances of normal tissue. Exceeding