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Stereotact Funct Neurosurg. 2018;96(5):289-295. doi: 10.1159/000493545. Epub 2018 Nov 7.

Re-Irradiation with Stereotactic Radiosurgery/Radiotherapy for Recurrent High-Grade Gliomas: Improved Survival in the Modern Era.

Author information

1
Division of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
2
Division of Medical Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, Pennsylvania, USA.
3
Division of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA, Rodney.Wegner@ahn.org.

Abstract

OBJECTIVE:

The aim of this study was to evaluate the efficacy of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) as salvage therapy for recurrent high-grade glioma and to look at the overall efficacy of treatment with linear accelerator (LINAC)-based radiosurgery and fractionated radiotherapy.

METHODS:

From 2010 to 2017, a total of 25 patients aged 23-74 years were re-irradiated with LINAC-based SRS and fSRT. Patients were treated to a median dose of 25 Gy in 5 fractions.

RESULTS:

The median overall survival (OS) after (initial) diagnosis was 39 months with an actuarial 1-, 3-, and 5-year OS rate of 88, 56, and 30%, respectively. After treatment with SRS or fSRT, the median OS was 9 months with an actuarial 1-year OS rate of 29%. Local control, assessed for 28 tumors, after 6 months was 57%, while local control after 1 year was 39%. Three patients experienced local failure. There was no evidence of toxicity noted after SRS or fSRT throughout the follow-up period.

CONCLUSION:

SRS and fSRT remain a safe, reasonable, effective treatment option for re-irradiation following recurrent glioblastoma. Additionally, treatment volume may predict local control in the salvage setting.

KEYWORDS:

Glioblastoma multiforme; Stereotactic radiosurgery; Stereotactic radiotherapy

PMID:
30404102
DOI:
10.1159/000493545

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