Gamma Knife Radiosurgery in Recurrent Glioblastoma
Gamma Knife Radiosurgery in Recurrent Glioblastoma
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DOI：
10.1159/000448924
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发表时间：
2016-01-01
影响因子：
1.7
通讯作者：
Gatterbauer, Brigitte
中科院分区：
文献类型：
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作者：
Frischer, Josa M.;Marosi, Christine;Gatterbauer, Brigitte
背景：我们评估了伽玛刀放射外科（GKRS）作为复发性胶质母细胞瘤患者的治疗选择。患者和方法：42 名经组织病理学诊断为复发性 IV 级肿瘤的患者接受了 GKRS 治疗。所有患者均接受了标准多模式一线治疗。从诊断到 GKRS 的平均时间为 17.0 个月。中位靶体积为 5.1 cm(3)。中位边缘剂量为 10 Gy，中位中心剂量为 20 Gy。在一部分患者中，通过焦磷酸测序进行了 O-6-甲基鸟嘌呤甲基转移酶 (MGMT) 启动子甲基化分析。结果：大多数患者在 GKRS 后没有出现并发症。初次 GKRS 后出现放射学进展的时间为 4.4 个月（95% CI：3.1-5.7 个月）。放射学进展主要发生在 GKRS 照射区域之外。初次 GKRS 后的中位生存时间为 9.6 个月（95% CI：7.7-11.5 个月）。诊断后的中位总生存时间为 25.6 个月（95% CI：21.8-29.3 个月）。与没有 MGMT 启动子甲基化的患者（16.0 个月；95% CI：8.0-23.9 个月）相比，MGMT 启动子甲基化的患者存活时间明显更长（33.4 个月；95% CI：21.2-45.5 个月）。结论：对于精心挑选的患者来说，GKRS 似乎是复发性胶质母细胞瘤相对安全的挽救治疗选择，但必须被视为多模式治疗算法的一部分。 (C) 2016 S. Karger AG，巴塞尔
Background: We evaluated Gamma Knife radiosurgery (GKRS) as a treatment option for patients with recurrent glioblastoma. Patients and Methods: 42 patients with histopathologically diagnosed recurrent grade IV tumor were treated with GKRS. All patients had undergone standard multimodal first-line treatment. The average time from diagnosis to GKRS was 17.0 months. The median target volume was 5.1 cm(3). The median margin dose was 10 Gy and the median central dose 20 Gy. In a subset of patients, O-6-methylguanine methyltransferase (MGMT) promoter methylation analysis by pyrosequencing was performed. Results: Most patients did not develop complications after GKRS. Time to radiological progression after initial GKRS was 4.4 months (95% CI: 3.1-5.7 months). Radiological progression mainly occurred beyond the GKRS-irradiated area. The median survival time after initial GKRS was 9.6 months (95% CI: 7.7-11.5 months). The median overall survival time from diagnosis was 25.6 months (95% CI: 21.8-29.3 months). Patients with MGMT promoter methylation survived significantly longer (33.4 months; 95% CI: 21.2-45.5 months) compared to patients without MGMT promoter methylation (16.0 months; 95% CI: 8.0-23.9 months). Conclusion: GKRS seems to be a relatively safe salvage treatment option for recurrent glioblastoma for highly selected patients but must be seen as part of a multimodal treatment algorithm. (C) 2016 S. Karger AG, Basel