{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:28:48Z","timestamp":1792708128142,"version":"4.5.0"},"reference-count":51,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Purpose. For recurrent high-grade gliomas (HGG), no standard therapeutic approach has been reported; thus, surgery, chemotherapy, and re-irradiation (re-RT) may all be proposed. The aim of the study was to evaluate safety and efficacy of re-RT by radiosurgery or fractionated stereotactic radiotherapy (SRS\/FSRT) in association to chemotherapy in patients with recurrent HGG. Material\/Methods: All patients with histological diagnosis of HGG that suffered by recurrent disease diagnosed by magnetic resonance imaging (MRI), according to Response Assessment in Neuro-Oncology (RANO) criteria, after primary\/adjuvant chemo-radiotherapy treatment and underwent to re-RT by SRS\/FSRT were included in the analysis. Second-line chemotherapy was administered. Outcomes were evaluated by neurological examination and brain MRI performed 1 month after re-RT and then every 2\u20133 months. Results: From November 2019 to September 2021, 30 patients presenting recurrent HGG underwent re-RT. Median dose was 24 Gy (range 15\u201336 Gy), and median fractions was 5 (range 1\u20136). Twenty-one patients (70%) had RPA class \u2264 IV. One patient had a histological diagnosis of anaplastic oligodendroglioma, 24 patients (80%) were affected by glioblastoma (GBM) including 3 cases of multifocal form, and 5 patients (17%) by anaplastic astrocytoma. Median time between primary\/adjuvant RT and disease recurrence was 8 months. In six cases (20%) re-operation was performed, and in most cases (87%), a second line of systemic therapy was administrated. At a median follow-up time from recurrence of 13 months (range 6\u201356 months), 10 patients (33%) were alive: 2 patients with partial response disease, 7 patients with stable disease, and 1 patient with out-field progression disease. Of the 20 patients who died (67%), 15 (75%) died for progression disease and 5 (25%) for other causes (3 due to septic event, 1 due to thrombo-embolic event, and 1 due to car accident). Median OS and PFS after recurrence were 12.1 and 11.2 months. Six-month and one-year OS were, respectively, 81% and 51%. No acute or late neurological side effects grade \u2265 2 and no case of radio-necrosis were reported. One patient experienced, after reintervention and during Regorafenib treatment (administered 40 days after surgery), dehiscence of the surgical wound. In three cases, grade 2 distal paresthesia was reported. Grade 3\u20134 hematologic toxicity occurred in seven cases. Three case of grade 5 toxicities during chemotherapy were reported: three septic events and one thrombo-embolic event. Conclusion. Re-RT with SRT\/FSRT in association with second-line systemic therapy is a safe and feasible treatment for patients with HGG recurrence. Validation of these results by prospective studies is needed.<\/jats:p>","DOI":"10.3390\/jpm12081336","type":"journal-article","created":{"date-parts":[[2022,8,21]],"date-time":"2022-08-21T23:51:01Z","timestamp":1661125861000},"page":"1336","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Radiosurgery and Stereotactic Brain Radiotherapy with Systemic Therapy in Recurrent High-Grade Gliomas: Is It Feasible? Therapeutic Strategies in Recurrent High-Grade Gliomas"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9947-9650","authenticated-orcid":false,"given":"Fabiana","family":"Gregucci","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Surgo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Carbonara","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Laera","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Paola","family":"Ciliberti","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Annunziata","family":"Gentile","sequence":"additional","affiliation":[{"name":"Department of Radiology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morena","family":"Caliandro","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Sasso","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Bonaparte","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Fanelli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Tortora","sequence":"additional","affiliation":[{"name":"Centro Orientamento Oncologico, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Paulicelli","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giammarco","family":"Surico","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1316-2132","authenticated-orcid":false,"given":"Giuseppe","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5040-1916","authenticated-orcid":false,"given":"Francesco","family":"Signorelli","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neurosciences and Sense Organs, Division of Neurosurgery, University \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4201-5852","authenticated-orcid":false,"given":"Alba","family":"Fiorentino","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Acquaviva delle Fonti (BA), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3322\/canjclin.56.2.106","article-title":"Cancer statistics","volume":"56","author":"Jemal","year":"2006","journal-title":"CA Cancer J Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1056\/NEJMoa043330","article-title":"Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma","volume":"352","author":"Stupp","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S1470-2045(09)70025-7","article-title":"Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial","volume":"10","author":"Stupp","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s11060-014-1524-0","article-title":"Hypofractionated stereotactic reirradiation for recurrent glioblastoma","volume":"120","author":"Yazici","year":"2014","journal-title":"J. Neurooncol."},{"key":"ref_5","first-page":"657953","article-title":"Salvage radiosurgery for selected patients with recurrent malignant gliomas","volume":"2014","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1748-717X-4-11","article-title":"Stereotactic radiosurgery for glioblastoma: Retrospective analysis","volume":"4","author":"Biswas","year":"2009","journal-title":"Radiat. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"757","DOI":"10.3171\/2014.11.JNS13295","article-title":"Role of adjuvant or salvage radiosurgery in the management of unresected residual or progressive glioblastoma multiforme in the pre-bevacizumab era","volume":"122","author":"Niranjan","year":"2015","journal-title":"J. Neurosurg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s11060-011-0744-9","article-title":"Salvage gamma knife stereotactic radiosurgery followed by bevacizumab for recurrent glioblastoma multiforme: A case\u2013control study","volume":"107","author":"Park","year":"2012","journal-title":"J. Neurooncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s11060-008-9752-9","article-title":"Salvage reirradiation for recurrent glioblastoma with radiosurgery: Radiographic response and improved survival","volume":"92","author":"Patel","year":"2009","journal-title":"J. Neurooncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/j.wneu.2012.03.024","article-title":"\u03b3 knife surgery versus reoperation for recurrent glioblastoma multiforme","volume":"78","author":"Skeie","year":"2012","journal-title":"World Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1007\/s12094-018-1957-6","article-title":"Re-irradiation of recurrent glioblastoma as part of a sequential multimodality treatment concept","volume":"21","author":"Lampl","year":"2019","journal-title":"Clin Transl Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000448924","article-title":"Gamma knife radiosurgery in recurrent glioblastoma","volume":"94","author":"Frischer","year":"2016","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"ref_13","unstructured":"National Comprehensive Cancer Network (2022, August 01). Central Nervous System Cancers (Version 2022). Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/cns_blocks.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.3171\/2012.9.JNS12504","article-title":"Impact of extent of resection for recurrent glioblastoma on overall survival: Clinical article","volume":"117","author":"Bloch","year":"2012","journal-title":"J. Neurosurg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4733","DOI":"10.1200\/JCO.2008.19.8721","article-title":"Bevacizumab Alone and in Combination with Irinotecan in Recurrent Glioblastoma","volume":"27","author":"Friedman","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/S1470-2045(18)30675-2","article-title":"Regorafenib compared with lomustine in patients with relapsed glioblastoma (REGOMA): A multicentre, open-label, randomised, controlled, phase 2 trial","volume":"20","author":"Lombardi","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s11060-018-03059-x","article-title":"Re-irradiation for recurrent glioma: Outcome evaluation, toxicity and prognostic factors assessment. A multicenter study of the Radiation Oncology Italian Association (AIRO)","volume":"142","author":"Navarria","year":"2019","journal-title":"J. Neurooncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"206","DOI":"10.3389\/fonc.2019.00206","article-title":"Role of Radiosurgery\/Stereotactic Radiotherapy in Oligometastatic Disease: Brain Oligometastases","volume":"9","author":"Mazzola","year":"2019","journal-title":"Front. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1007\/s00432-020-03152-7","article-title":"AIRO Giovani-Italian association of radiation oncology-young members. volume de-escalation in radiation therapy: State of the art and new perspectives","volume":"146","author":"Meduri","year":"2020","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3048","DOI":"10.1200\/JCO.2009.25.6941","article-title":"Hypofractionated Stereotactic Radiation Therapy: An Effective Therapy for Recurrent High-Grade Gliomas","volume":"28","author":"Fogh","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.4103\/0973-1482.199537","article-title":"Salvage stereotactic radiosurgery for recurrent glioblastoma multiforme with prior radiation therapy","volume":"12","author":"Holt","year":"2016","journal-title":"J. Cancer Res. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s12094-017-1763-6","article-title":"SEOM clinical guidelines for diagnosis and treatment of glioblastoma (2017)","volume":"20","author":"Carrato","year":"2018","journal-title":"Clin. Transl. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"253","DOI":"10.7785\/tcrt.2012.500200","article-title":"Re-irradiation with radiosurgery for recurrent glioblastoma multiforme","volume":"10","author":"Torok","year":"2011","journal-title":"Technol. Cancer Res. Treat."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1159\/000493545","article-title":"Re-irradiation with stereotactic radiosurgery\/radiotherapy for recurrent high-grade gliomas: Improved survival in the modern era","volume":"96","author":"Gigliotti","year":"2018","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1093\/jnci\/92.3.205","article-title":"New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada","volume":"92","author":"Therasse","year":"2000","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s00432-018-2781-7","article-title":"First Experience and Clinical Results Using a New Non-Coplanar Mono-Isocenter Technique (HyperArcTM) for Linac-Based VMAT Radiosurgery in Brain Metastases","volume":"145","author":"Alongi","year":"2019","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Gregucci, F., Bonaparte, I., Surgo, A., Caliandro, M., Carbonara, R., Ciliberti, M.P., Aga, A., Berloco, F., De Masi, M., and De Pascali, C. (2021). Brain Linac-based Radiation Therapy: \u201cTest Drive\u201d of New Immobilization Solution and Surface Guided Radiation Therapy. J. Pers. Med., 11.","DOI":"10.3390\/jpm11121351"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Gregucci, F., Surgo, A., Bonaparte, I., Laera, L., Ciliberti, M.P., Carbonara, R., Gentile, M.A., Giraldi, D., Calbi, R., and Caliandro, M. (2021). Poor-Prognosis Patients Affected by Glioblastoma: Retrospective Study of Hypofractionated Radiotherapy with Simultaneous Integrated Boost and Concurrent\/Adjuvant Temozolomide. J. Pers. Med., 11.","DOI":"10.3390\/jpm11111145"},{"key":"ref_29","first-page":"132","article-title":"High-dose re-irradiation of intracranial lesions\u2014Efficacy and safety including dosimetric analysis based on accumulated EQD2Gy dose EQD calculation","volume":"27","author":"Stiefel","year":"2021","journal-title":"Clin. Transl. Radiat. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1002\/cncr.11845","article-title":"Salvage therapy in patients with glioblastoma: Is there any benefit?","volume":"98","author":"Hau","year":"2003","journal-title":"Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1097\/00006123-199710000-00004","article-title":"Survival benefit of stereotactic radiosurgery for patients with malignant glial neoplasms","volume":"41","author":"Kondziolka","year":"1997","journal-title":"Neurosurgery"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.ijrobp.2008.10.043","article-title":"Safety and efficacy of bevacizumab with hypofractionated stereotactic irradiation for recurrent malignant gliomas","volume":"75","author":"Gutin","year":"2009","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Vordermark, D., Kolbl, O., Ruprecht, K., Vince, G.H., Bratengeier, K., and Flentje, M. (2005). Hypofractionated stereotactic re-irradiation: Treatment option in recurrent malignant glioma. BMC Cancer, 5.","DOI":"10.1186\/1471-2407-5-55"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000505706","article-title":"Stereotactic Radiotherapy in Recurrent Glioblastoma: A Valid Salvage Treatment Option","volume":"98","author":"Yaprak","year":"2020","journal-title":"Ster. Funct. Neurosurg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.wneu.2010.12.053","article-title":"Efficacy of gamma knife radiosurgery for small-volume recurrent malignant gliomas after initial radical resection","volume":"76","author":"Elliott","year":"2011","journal-title":"World Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.ijrobp.2005.01.056","article-title":"Reirradiation of recurrent high-grade gliomas using amino acid PET (SPECT)\/CT\/MRI image fusion to determine gross tumor volume for stereotactic fractionated radiotherapy","volume":"63","author":"Grosu","year":"2005","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.clon.2018.05.004","article-title":"A Retrospective Review of Re-irradiating Patients\u2019 Recurrent High-grade Gliomas","volume":"30","author":"Klobukowski","year":"2018","journal-title":"Clin. Oncol. R. Coll. Radiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3389\/fonc.2015.00106","article-title":"Salvage Fractionated Stereotactic Radiotherapy with or without Chemotherapy and Immunotherapy for Recurrent Glioblastoma Multiforme: A Single Institution Experience","volume":"5","author":"Hasan","year":"2015","journal-title":"Front. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.ejca.2012.02.004","article-title":"New prognostic factors and calculators for outcome prediction in patients with recurrent glioblastoma: A pooled analysis of EORTC Brain Tumour Group phase I and II clinical trials","volume":"48","author":"Gorlia","year":"2012","journal-title":"Eur. J. Cancer"},{"key":"ref_40","first-page":"364","article-title":"Reirradiation of recurrent high-grade glioma and development of prognostic scores for progression and survival","volume":"6","author":"Chapman","year":"2019","journal-title":"Neurooncol. Pract."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s00701-011-1184-1","article-title":"Efficacy and toxicity of CyberKnife re-irradiation and \u201cdose dense\u201d temozolomide for recurrent gliomas","volume":"154","author":"Conti","year":"2012","journal-title":"Acta Neurochir."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s11060-014-1394-5","article-title":"Re-irradiation and bevacizumab in recurrent highgrade glioma: An effective treatment option","volume":"117","author":"Flieger","year":"2014","journal-title":"J. Neurooncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s11060-018-03064-0","article-title":"Re-irradiation for recurrent glioblastoma (GBM): A systematic review and meta-analysis","volume":"142","author":"Kazmi","year":"2019","journal-title":"J. Neuro-Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.radonc.2021.12.019","article-title":"Re-irradiation for recurrent high grade glioma (HGG) patients: Results of a single arm prospective phase 2 study","volume":"167","author":"Navarria","year":"2022","journal-title":"Radiother. Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1097\/00006123-199804000-00013","article-title":"Survival and functional status after resection of recurrent glioblastoma multiforme","volume":"42","author":"Barker","year":"1998","journal-title":"Neurosurgery"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1227\/00006123-198711000-00002","article-title":"Reoperation for recurrent glioblastoma and anaplastic astrocytoma","volume":"21","author":"Harsh","year":"1987","journal-title":"Neurosurgery"},{"key":"ref_47","first-page":"1743","article-title":"The effect of re-operation on survival in patients with recurrent glioblastoma","volume":"35","author":"Franceschi","year":"2015","journal-title":"Anticancer Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3838","DOI":"10.1200\/JCO.2010.30.0582","article-title":"Scale to predict survival after surgery for recurrent glioblastoma multiforme","volume":"28","author":"Park","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.clineuro.2012.08.030","article-title":"The impact of repeated surgery and adjuvant therapy on survival for patients with recurrent glioblastoma","volume":"115","author":"Fiorentino","year":"2013","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.radonc.2018.05.024","article-title":"Survival gain with re-Op\/RT for recurred high-grade gliomas depends upon risk groups","volume":"128","author":"Chun","year":"2018","journal-title":"Radiother. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Leone, A., Colamaria, A., Fochi, N.P., Sacco, M., Landriscina, M., Parbonetti, G., de Notaris, M., Coppola, G., De Santis, E., and Giordano, G. (2022). Recurrent Glioblastoma Treatment: State of the Art and Future Perspectives in the Precision Medicine Era. Biomedicines, 10.","DOI":"10.3390\/biomedicines10081927"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/8\/1336\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:12:54Z","timestamp":1760141574000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/8\/1336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,20]]},"references-count":51,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["jpm12081336"],"URL":"https:\/\/doi.org\/10.3390\/jpm12081336","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,20]]}}}