Salvage fractionated stereotactic re-irradiation (FSRT) for patients with recurrent high grade gliomas progressed after bevacizumab treatment

Wenyin Shi, Erik S. Blomain, Joshua Siglin, Joshua J. Palmer, Tu Dan, Yang Wang, Maria Werner-Wasik, Jon Glass, Lyndon Kim, Voichita Bar Ad, Deepak Bhamidipati, James J. Evans, Kevin Judy, Christopher J. Farrell, David W. Andrews

Research output: Contribution to journalArticle

4 Scopus citations


Bevacizumab failure is a major clinical problem in the management of high grade gliomas (HGG), with a median overall survival (OS) of < 4 months. This study evaluated the feasibility and efficacy of fractionated stereotactic re-irradiation (FSRT) for patients progressed after Bevacizumab treatment. Retrospective review was conducted of 36 patients treated with FSRT after progression on bevacizumab. FSRT was most commonly delivered in 3.5 Gy fractions to a total dose of 35 Gy. Survival from initial diagnosis, as well as from recurrence and re-irradiation, were utilized as study endpoints. Univariate and multivariate analysis was performed. The median time from initial bevacizumab treatment to FSRT was 8.5 months. The median plan target volume for FSRT was 27.5 cc. The median OS from FSRT was 4.8 months. FSRT treatment was well tolerated with no grade 3 or higher toxicity. Favorable outcomes were observed in patients with recurrent HGG who received salvage FSRT after bevacizumab failure. The treatment was well tolerated. Prospective study is warranted to further evaluate the efficacy of salvage FSRT for selected patients with recurrent HGG amenable to FSRT, who had failed bevacizumab treatment.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalJournal of Neuro-Oncology
Publication statusAccepted/In press - Dec 12 2017



  • Bevacizumab
  • Glioblastoma
  • High grade glioma
  • Re-irradiation
  • Stereotactic radiation

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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