Accelerated Hypofractionated Intensity - Modulated Radiotherapy After Hyperbaric Oxygenation for Recurrent High Grade Glioma.

Inclusion Criteria

• •1. Male or Female, aged \>18 years.
• •2. Karnofsky Performance Scale (KPS)\> 60
• •3. Imaging confirmation of first tumor progression o regrowth as defined by Response Assessment in Neuro-Oncology Criteria (RANO) criteria at least 12 weeks after completion of radiotherapy, unless the recurrence is outside the radiation field or has been histologically documented
• •4. Recurrence after adjuvant treatment( surgery followed by radiotherapy and chemotherapy) in patients who could receive further therapeutic interventions
• •5. No more than one prior line of chemotherapy (one line of chemotherapy after concurrent and adjuvant Temozolomide (TMZ) - based chemotherapy or procarbazine/lomustine/vincristine (PCV) - Radiotherapy (RT)
• •6. Patients who have undergone recent surgery for recurrent o progressive high grade gliomas are eligible provided that : surgery must have confirmed the recurrence ; a minimum of 28 days must have elapsed from the days of surgery to study . For core or needle biopsy a minimum of 7 days must have elapsed prior to study .
• •7. If female and of child bearing potential , have a negative result on a pregnancy test performed a maximum of 7 days before initiation .
• •8. Female participants of child bearing potential and male participants whose partner is of child bearing potential must be willing to ensure that they or their partner use effective contraception during the study and for 4 months thereafter
• •9. Have adequate bone marrow function , liver function , and renal function , as measured by following laboratory assessments conducted within 7 days prior to the initiation of study treatment .
• •10. Hemoglobin \>9.0 g/dl
• •11. Absolute neutrophil count (ANC) \>1500/mm3 without transfusions or granulocyte colony stimulating factor and other hematopoietic growth factors
• •12. Platelet count ≥90,000/μl
• •13. White Blood Cell (WBC) \>3.0 x 109/L
• •14. Total bilirubin \<1.5 times the upper limit of normal
• •15. Serum creatinine \<1.5 x upper limit of normal
• •16. Participant is willing and able to give informed consent for participation in the study.