Clinical Trial Finder

Inclusion Criteria:

1. The initial diagnosis confirmed by histopathology is World Health Organization WHO grade 4 glioma; 2. Surgery, radiotherapy, chemotherapy, and adjuvant chemotherapy (Stupp plan) are performed after the initial diagnosis, and recurrence according to the evaluation of neurotumor response (RANO) criteria and/or confirmed by histopathology; 3. The expected survival period is ≥3 months; 4. Age between 18 and 70 years old; 5. KPS score (KPS) ≥ 70, able to take care of most of life, but occasionally need help from others; 6. There are measurable lesions on the T1 enhancement sequence of the head MRI; 7. Hematopoietic function: hemoglobin ≥90g/L, platelets ≥90×109/L, white blood cells ≥4×109/L (previous chronic anemia 80-90 g/L or previous low white blood cell level 3-4×109/L Or thrombocytopenia 80-90×109/L, but KPS 70-100 can be considered for admission) (The range of normal values can be fine-tuned due to the different standards of tertiary first-class hospitals); 8. Liver function: ALT and AST<1.5 times of high normal (ULN), bilirubin<1.5×ULN; 9. Sign the informed consent form; 10. Agree to participate in follow-up actions.

Exclusion Criteria:

1. Other invasive malignant tumors; 2. Re-irradiation after receiving recurrence in the past; 3. Recurrence more than 3 times or evidence that there is a subdural recurrence disease or a tumor with a maximum diameter of more than 6 cm; 4. Treat with vascular endothelial growth factor (VEGF) or VEGFR inhibitor or irinotecan in advance; 5. Pregnant or nursing mothers; 6. Participate in other tests after diagnosis of recurrence; 7. According to CTCAE5.0 standard classification of patients with bleeding above grade 3; 8. Symptomatic peripheral vascular disease; 9. Known allergy to bevacizumab or irinotecan; 10. Patients who are treated with anticoagulants or vitamin K antagonists such as warfarin, heparin or their analogs; under the premise that the prothrombin time international normalized ratio (INR) is ≤1.5, the use of small doses of Huafa for preventive purposes is allowed Farin (1 mg orally, once a day) or low-dose aspirin (do not exceed 100 mg per day); 11. Abnormal blood coagulation function, bleeding tendency (such as active peptic ulcer) or receiving thrombolysis or anticoagulation therapy; 12. Arterial/venous thrombotic events that occurred within 6 months before the first medication, such as cerebrovascular accidents (including temporary ischemic attacks), deep vein thrombosis and pulmonary embolism; 13. Urine routine test showed urine protein ≥++ and confirmed 24-hour urine protein quantification>1.0 g; 14. Long-term unhealed wounds or fractures; 15. Suffering from severe cardiovascular disease: myocardial ischemia or myocardial infarction above grade II, poor arrhythmia control (including men with QTc interval ≥450 ms, women ≥470 ms); according to NYHA standards, III to Grade IV insufficiency or color Doppler ultrasonography of the heart shows that the left ventricular ejection fraction (LVEF) is less than 50%; 16. Patients with hypertension who cannot be well controlled by a single antihypertensive drug treatment (systolic blood pressure> 140 mmHg, diastolic blood pressure> 90 mmHg), suffering from myocardial ischemia or myocardial infarction, arrhythmia (including QT room Period ≥440 ms) and degree I cardiac insufficiency; 17. History of organ transplantation; 18. According to the judgment of the researcher, a serious disease that endangers the safety of the patient or affects the completion of the study. 19. Poor overall health, even KPS<60; 20. Unable to understand the purpose of treatment or unwilling to sign the treatment consent form; 21. No capacity for civil conduct or limited capacity for civil conduct.

Arms

Experimental: Treatment arm

irinotecan + bevacizumab + Re-radiotherapy

Interventions

Drug: - Bevacizumab，Irinotecan and Re-radiotherapy

All patients with recurrent glioblastoma will accept irinotecan and bevacizumab combined with re-radiotherapy .