Stereotactic radiosurgery for glioblastoma: retrospective analysis.
Stereotactic radiosurgery for glioblastoma: retrospective analysis.
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DOI：
10.1186/1748-717x-4-11
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发表时间：
2009-03-17
期刊：
影响因子：
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通讯作者：
Milano MT
中科院分区：
文献类型：
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作者：
Biswas T;Okunieff P;Schell MC;Smudzin T;Pilcher WH;Bakos RS;Vates GE;Walter KA;Wensel A;Korones DN;Milano MT
这项回顾性研究的目的是更好地了解立体定向放射外科（SRS）治疗胶质母细胞瘤可能有效的条件。在2000年至2007年期间，33例病理诊断为胶质母细胞瘤的患者使用Novalis®塑形射束放射外科系统接受了SRS。18例患者（54%）接受了复发的补救SRS，而15例（45%）患者在标准分次RT后接受了新诊断的胶质母细胞瘤的前期SRS。无RTOG>2级急性副作用。SRS后的中位生存期为6.7个月（范围1.4 - 74.7）。在SRS的时间方面，总生存期（从最初诊断的时间起）没有显著差异（p = 0.2）。与复发时相比，接受SRS巩固治疗的患者的无进展生存率显著更高（p = 0.04）。大多数患者在SRS治疗体积内或边缘失败（21/26例可评价复发）。SRS在胶质母细胞瘤治疗中耐受性良好。由于无论是在复发前还是复发时给予SRS，生存率均无差异，因此应对每位患者进行个体化治疗。未来的研究需要确定最有可能对SRS有反应的患者。
This retrospective study was done to better understand the conditions for which stereotactic radiosurgery (SRS) for glioblastoma may be efficacious. Between 2000 and 2007, 33 patients with a pathological diagnosis of glioblastoma received SRS with the Novalis® Shaped Beam Radiosurgery system. Eighteen patients (54%) underwent salvage SRS for recurrence while 15 (45%) patients received upfront SRS following standard fractionated RT for newly diagnosed glioblastoma. There were no RTOG grade >2 acute side effects. The median survival after SRS was 6.7 months (range 1.4 – 74.7). There was no significant difference in overall survival (from the time of initial diagnosis) with respect to the timing of SRS (p = 0.2). There was significantly better progression free survival in patients treated with SRS as consolidation versus at the time of recurrence (p = 0.04). The majority of patients failed within or at the margin of the SRS treatment volume (21/26 evaluable for recurrence). SRS is well tolerated in the treatment of glioblastoma. As there was no difference in survival whether SRS is delivered upfront or at recurrence, the treatment for each patient should be individualized. Future studies are needed to identify patients most likely to respond to SRS.