Table 2.
Patients characteristics II, salvage treatment, time from first to second progression and time from initial diagnosis to death
| Patient | Location of first relapse | Salvage treatment and further course of disease | R (C) T 2 (Gy)/fractions/ concurrent chemotherapy | Time from start of second RT to progression (months) | Time from start of second RT to death (months) | Time from first relapse to death (months) |
|---|---|---|---|---|---|---|
| 1 | margin of RT 1 field | sRCT → PCV → PD → death | 24.2/5/ TMZ | 3.2 | 4.6 | 4.9 |
| 2 | margin of RT 1 field | pSx (GBM) → CT (MTX + TMZ) → second relapse → RCT 2 → mCT (TMZ) → PD → nimotuzumab → PD → death | 55.8/31/TMZ | 2.4 | 6.1 | 20.5 |
| 3 | margin of RT 1 field | pSx → RT 2 → PD → dendritic cell vaccination → PD → dendritic cell vaccination + TMZ → PD → death | 30/6 | 1.6 | 3.8 | 5.3 |
| 4 | margin of RT 1 field | RCT 2 → COMBAT chemotherapy → multilocular recurrence → lomustine, trofosfamide → death | 30.6/17/TMZ | 35.9 | 38.3 | 39.5 |
| 5 | within RT 1 field | TMZ → PD → RT 2 → 30.6/17 → bevacizumab → multilocular recurrence → irinotecan + bevacizumab → death | 30.6/17 | 2.9 | 6.7 | 11.5 |
| 6 | multilocular, outside RT 1 field | RCT 2 (cerebellar peduncle) → mCT (TMZ) → RT 3 (30,6 Gy, lateral ventricle) → PD → TMZ → multilocular progress → TMZ + RT 4 (3 × 5 Gy, cerebellopontine angle) → PD → death | 45/25/TMZ | not reasonably measurable* | 10.3 | 11.3 |
| 7 | within RT 1 field | pSx → dendritic cell vaccination → extensive dissemination → RCT 2 (CSI + TMZ) → PD death | 30/10 /TMZ | 1.4 | 3.9 | 10.6 |
| 8 | outside RT 1 field | watch and wait →local PD and metastasis to cerebellum → RT (cerebellum) → multilocular relapse → further treatment refused → death | 54/30 | not reasonably measurable* | 9.2 | 20.0 |
RT: radiation therapy, RCT: radiochemotherapy, sRCT: stereotactic radiotherapy + concurrent chemotherapy, PCV: procarbazine, lomustine, vincristine, PD: progressive disease, TMZ: temozolomide, pSx: partial surgery, GBM: glioblastoma multiforme (WHO grade IV), CT: chemotherapy, MTX: methotrexate, mCT: maintenance chemotherapy, COMBAT: Combined Oral Metronomic Biodifferentiating Antiangiogenic Treatment (including low-dose daily temozolomide, etoposide, celecoxib, vitamin D, fenofibrate and retinoic acid), CSI: craniospinal irradiation. →: followed by the next treatment.
*as only part of the relapsed tumor deposits were irradiated.