Abstract 376P
Background
The treatment of recurrent high-grade glioma (HGG) is difficult, and reoperation cannot effectively control the progress of the disease. The side effects and complications of radiotherapy limit its effective application again. Stereotactic radiotherapy (CyberKnife) can increase the dose to the tumour target and reduce the dose on surrounding normal tissues. There are few reports on the treatment of recurrent HGG by CyberKnife combined with bevacizumab and temozolomide.
Methods
From October 2014 to February 2019, 67 cases of recurrent HGG were treated. There were 37 cases in group A and 30 cases in group B. Both groups were given bevacizumab at a dose of 5mg / kg, intravenous drip, once every two weeks, for at least four cycles, and the CyberKnife treatment started at the same time. In group A, this was combined with temozolomide treatment: during the CyberKnife treatment, 75mg / m2 daily, two weeks; one month after the end of the CyberKnife treatment, 150mg / m2, daily, oral for 5 days, rest 23 days, and then repeated for 4-6 cycles. The radiation dosage of CyberKnife treatment in the two groups was 24Gy-36Gy / 4-8 fractions. The effect was evaluated after 3 months of the CyberKnife treatment, and was then evaluated every 3 months.
Results
After 3 months of CyberKnife treatment- Group A: The clinical control rate (DCR) was 94.6% (35 / 37), the mean overall survival was 14.4 months, the median overall survival was 12 months, the one-year survival rate was 48.6%; Group B: DCR was 86.7% (26 / 30), the mean overall survival time was 11.2 months, the median overall survival time was 10 months, the one-year survival rate was 33.3%. The difference between the two groups was statistically significant (x2 = 4.825, P = 0.028); There was no significant difference in the DCR between the two groups (χ2 = 1.277, P = 0.258); The improvement rates of headache and nausea, and limb disorders were 83.9% (26 / 31) and 75.9% (22 / 29), respectively, in group A, and 80.8% (21 / 26) and 73.9%, respectively, (17 / 23) in group B.
Conclusions
The results show that the combination of bevacizumab and temozolomide may improve the survival rate and overall survival of recurrent HGG and improve the clinical symptoms without increasing the serious side effects of the nervous system.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Jingbo Kang.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.