PMID- 37972737
OWN - NLM
STAT- MEDLINE
DCOM- 20240220
LR  - 20240226
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 190
DP  - 2024 Jan
TI  - Brachytherapy is an effective and safe salvage option for re-irradiation in 
      recurrent glioblastoma (rGBM): A systematic review.
PG  - 110012
LID - S0167-8140(23)09319-2 [pii]
LID - 10.1016/j.radonc.2023.110012 [doi]
AB  - PURPOSE: To evaluate the clinical efficacy and toxicity of brachytherapy as a 
      salvage therapy for patients with recurrent glioblastoma (rGBM). METHODS AND 
      MATERIALS: We searched the PubMed, Embase, and Cochrane libraries from its 
      inception to June 2023, for eligible studies in which patients underwent 
      brachytherapy for rGBM. Outcomes of interest were mOS, mPFS, OS, PFS, and adverse 
      events (AEs). For individual clinical survival outcomes and common AEs, 
      weighted-mean descriptive statistics were calculated as a summary measure using 
      study sample size as the weight. The calculation formula is as follows: 
      weighted-mean = Sigmawx/Sigmaw (w is the sample size and x is the outcome). RESULTS: This 
      review included 29 studies with a total of 1202 rGBM patients, including 22 
      retrospective and 7 prospective studies. The results showed that from the time of 
      brachytherapy, the mOS and mPFS were 6.8 to 24.4 months and 3.7 to 11.7 months. 
      The OS of 6 months, 1 year, 18 months, 2 years, and 3 years after brachytherapy 
      were 58.3 % to 85.2 % (weighted-mean 76.2 %), 26 % to 66 % (weighted-mean 
      41.9 %), 20 % to 37 % (weighted-mean 27.6 %), 11 % to 23 % (weighted-mean 
      14.8 %), and 8 % to 15 % (weighted-mean 12.1 %), respectively. The PFS of 
      6 months and 1 year after brachytherapy were 26.7 % to 86 % (weighted-mean 
      53.4 %) and 14 % to 81 % (weighted-mean 24.1 %). Most patients with rGBM will 
      experience treatment failure again during the follow-up period, mainly local 
      (10.7 % to 79.4 %) or marginal(3.6 % to 22.2 %) recurrence, followed by distant 
      failure (6.7 % to 57.7 %). Although therapeutic AEs had not been uniformly 
      reported, the overall toxicity rate was considered to be low. The common AEs 
      reported included progressive neurologic deterioration, seizures, CSF leak, brain 
      necrosis, hemorrhage, and infection/meningitis, with a weighted-mean incidence of 
      1.9 %, 2.4 %, 4.1 %, 5.4 %, 2.1 %, and 3.8 %, respectively. CONCLUSIONS: The 
      evidence summarized above, albeit mostly level III, suggests that brachytherapy 
      has acceptable safety and good post-treatment clinical efficacy for selected 
      patients with rGBM. Well-designed, high-quality, large-sample randomized 
      controlled and prospective studies are needed to further validate these findings.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Xiang, Xiaoyong
AU  - Xiang X
AD  - Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China.
FAU - Ji, Zhe
AU  - Ji Z
AD  - Department of Radiation Oncology, Peking University Third Hospital, 49 North 
      Garden Road, Haidian District, Beijing 100191, China.
FAU - Jin, Jing
AU  - Jin J
AD  - Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy 
      of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China; 
      Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences 
      and Peking Union Medical College, Beijing 100021, China. Electronic address: 
      jingjin@163.com.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20231114
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Humans
MH  - *Re-Irradiation/adverse effects/methods
MH  - *Glioblastoma/radiotherapy
MH  - *Brachytherapy/adverse effects/methods
MH  - Retrospective Studies
MH  - Prospective Studies
MH  - Neoplasm Recurrence, Local
MH  - Salvage Therapy/methods
OTO - NOTNLM
OT  - Brachytherapy
OT  - Glioblastoma
OT  - Recurrent
OT  - Salvage therapy
OT  - Systematic analysis
COIS- Declaration of competing interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/11/17 15:26
MHDA- 2024/02/20 11:50
CRDT- 2023/11/16 19:26
PHST- 2023/09/03 00:00 [received]
PHST- 2023/10/30 00:00 [revised]
PHST- 2023/11/01 00:00 [accepted]
PHST- 2024/02/20 11:50 [medline]
PHST- 2023/11/17 15:26 [pubmed]
PHST- 2023/11/16 19:26 [entrez]
AID - S0167-8140(23)09319-2 [pii]
AID - 10.1016/j.radonc.2023.110012 [doi]
PST - ppublish
SO  - Radiother Oncol. 2024 Jan;190:110012. doi: 10.1016/j.radonc.2023.110012. Epub 
      2023 Nov 14.