Reirradiation in primary or secondary brain tumors

The purpose of this review was to analyze data available on reirradiation for high-grade glioma or brain metastasis. This reirradiation can be 3D conformal or stereotactic. There are no randomized trials. No definitive recommendations can be given but solutions can be proposed. In high-grade gliomas, results of 3D conformal irradiation are fair. Stereotactic irradiation produces more encouraging survival rates but the range of doses delivered is too large for allowing recommendations. However, fractions less than 5 Gy seem better tolerated. In brain metastases, total brain irradiation seems useful if metastases are multiple and the patient in good condition. With radiosurgery, local control rates are high and survival encouraging. In a retrospective study, bifractionated irradiation looked interesting when compared to radiosurgery. Overall prospective trials seem to be necessary. (C) 2010 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.