Increased Survival Using Delayed Gamma Knife Radiosurgery for Recurrent High-Grade Glioma: A Feasibility Study
Increased Survival Using Delayed Gamma Knife Radiosurgery for Recurrent High-Grade Glioma: A Feasibility Study
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DOI：
10.1016/j.wneu.2014.06.011
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发表时间：
2014-11-01
影响因子：
2
通讯作者：
Lippitz, Bodo
中科院分区：
文献类型：
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作者：
Dodoo, Ernest;Huffmann, Beate;Lippitz, Bodo
目的：本研究回顾性评估了延迟伽玛刀治疗（GKRS）在治疗高级别胶质瘤复发中的作用。方法：在2001年至2007年期间，共有55例连续的高级别胶质瘤患者（包括68例世界卫生组织（WHO）III级和WHO IV级）接受了GKRS治疗局部复发。所有患者均接受了显微手术和放化疗，被认为是高级别胶质瘤的标准治疗。所有患者均获得完整随访;中位随访时间为17.2个月（2.5-114.2个月）。中位肿瘤体积为5.2 mL，处方剂量为20戈伊（14-22戈伊），中位最大剂量为45戈伊（30 ~ 77.3戈伊）。复发性GKRS后，这些患者的中位生存期为24.2个月，2年生存率为50%。WHO IV期肿瘤患者的中位生存期为24.5个月，2年生存率为51.4%。复发后用GKRS治疗，中位生存期为11.3个月，2年生存率：22.9%的WHO IV patients.CONCLUSION：目前的研究表明，高级别胶质瘤复发时，GKRS管理后的标准治疗的生存益处。与早期研究相比，这是一个相关的改进，早期研究未能提供在EBRT附近进行放射外科手术的有利效果。
OBJECTIVE: The current study retrospectively assessed delayed gamma knife radiosurgery (GKRS) in the management of high-grade glioma recurrences.METHODS: A total of 55 consecutive patientswith high-grade glioma comprising 68 World Health Organization (WHO) III and WHO IV were treated with GKRS for local recurrences between 2001 and 2007. All patients had undergone microsurgery and radiochemotherapy, considered as standard therapy for high-grade glioma. Complete follow-up was available in all patients; median follow-up was 17.2 months (2.5-114.2 months). Median tumor volume was 5.2 mL, prescription dose was 20 Gy (14-22 Gy), and median max dose was 45 Gy (30-77.3 Gy).RESULTS: The patients with WHO III tumors showed a median survival of 49.6 months with and a 2-year survival of 90%. After GKRS of the recurrences, these patients showed a median survival of 24.2 months and a 2-year survival of 50%. The patients with WHO IV tumors had a median survival of 24.5 months with a 2-year survival of 51.4%. After the recurrence was treated with GKRS, the median survival was 11.3 months and a 2-year survival: 22.9% for the WHO IV patients.CONCLUSION: The current study shows a survival benefit for high-grade glioma recurrences when GKRS was administered after standard therapy. This is a relevant improvement compared with earlier studies that had had not been able to provide a beneficial effect timing radiosurgery in close vicinity to EBRT.