concurrent hypofractionated three-dimensional re-irradiation and temozolomide in recurrent malignant glioma

background : this study determines the efficacy and tolerability of hypofraction- ated three-dimensional conformal radiotherapy in conjunction with daily temozolomide in treatment of previously irradiated recurrent malignant glioma. methods :we enrolled 21 patients diagnosed with recurrent or progressive malignant glioma who previously underwent external beam irradiation. all patients had hypofrac- tionated three-dimensional conformal radiotherapy to a total dose of 30 gy in six fractions, over a two-week period, concurrent with daily temozolomide (75 mg/m2). results : at the median follow up of 9.5 months (range: 2.5-42), there were 18 (86%) patients who had died. median overall survival from the onset of hypofractionated three- dimensional conformal radiotherapy was nine months and median time to progression was five months. there was no detectable severe toxicity. salvage surgery prior to hypofractionated three-dimensional conformal radiotherapy and planning target volume significantly influenced patient outcome according to multivariate analysis. conclusion : hypofractionated conformal re-irradiation concurrent with daily temozolomide is a feasible, well-tolerated treatment for recurrent malignant glioma. patients with surgical re-resection and smaller planning target volumes have the most favorable outcomes.