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Table 2 Patients characteristics II, salvage treatment, time from first to second progression and time from initial diagnosis to death

From: Reirradiation as part of a salvage treatment approach for progressive non-pontine pediatric high-grade gliomas: preliminary experiences from the German HIT-HGG study group

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

  1. 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.
  2. *as only part of the relapsed tumor deposits were irradiated.