Cyberknife re-irradiation for recurrent glioblastoma multiforme

Yıl 2018, Cilt: 5 Sayı: 9, 320 - 325, 30.09.2018

Ozlem Yersal

https://doi.org/10.17546/msd.458195

Öz

Objective:   Treatment of patients with recurrent glioblastoma multiforme (GBM) is challenging. Treatment alternatives include re-operation, chemotherapy and re-irridation. Stereotactic radiosurgery with cyberknife is a good therapeutic approach to deliver high-dose radiation to a definite target volume with minimizing re-irradiation to nearby healthy tissues. This study, evaluated the efficacy of cyberknife treatment in 24 patients with recurrent GBM. Methods: Total 24 patients with recurrent GBM who received cyberknife treatment in any line of recurrence between the 2011, 2015 were included in this study. A median dose of 30 Gy was applied to each patient. Results: Median survival was 10.3 months after cyberknife treatment and 23 months after diagnosis. Patients younger than 60 years (4.8 vs 14.2 month; p:0.05) and patients with primary total tumor excision (9.3 vs 4.9 month; p:0.05) had longer overall survival than other patients in univariate analysis but not in multivariate analysis. In this patient population, any other variables predicting longer overall survival could not be found. Treatment was well-tolerated and no severe toxicities observed. Conclusion: Although limitations exist, our study demonstrates that SRS in terms of cyberknife for recurrent GBM is feasible and well tolerated by patients with low toxicity.

Anahtar Kelimeler

Sterotactic radiotherapy, glioma

Kaynakça

• 1. Yersal O. Clinical outcome of patients with glioblastoma multiforme: Single center experience. Journal of Oncological Sciences 2017; 3:123-126.
• 2. Stupp R, Mason WP, van den Bent MJ, et al. European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups, National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352:987
• 3. Shi W, Blomain ES, Siglin J, Palmer JJ, Dan T, Wang Y, Werner-Wasik M, Glass J, Kim L, Bar Ad V, Bhamidipati D, Evans JJ, Judy K, Farrell CJ, Andrews DW. Salvage fractionated stereotactic re-irradiation (FSRT) for patients with recurrent high grade gliomas progressed after bevacizumab treatment. J Neurooncol. 2017 Dec 12. (Epub ahead of print)
• 4. Salvage fractionated stereotactic re-irradiation (FSRT) for patients with recurrent high grade gliomas progressed after bevacizumab treatment.
• 5. Shawn L. Hervey-Jumper, Mitchel S. Berger; Reoperation for Recurrent High-Grade Glioma: A Current Perspective of the Literature, Neurosurgery, 2014,75: 491–499.
• 6. Friedman HS, Prados MD, Wen PY, Mikkelsen T, Schiff D, Abrey LE et al (2009) Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol 27:4733–4740
• 7. Vredenburgh JJ, Desjardins A, Herndon JE 2nd, Marcello J, Reardon DA, Quinn JA et al (2007) Bevacizumab plus irinotecan in recurrent glioblastoma multiforme. J Clin Oncol 25:4722–4729
• 8. Vredenburgh JJ, Desjardins A, Herndon JE 2nd, Dowell JM, Reardon DA, Quinn JA et al (2007) Phase II trial of bevacizumab and irinotecan in recurrent malignant glioma. Clin Cancer Res 13:1253–1259
• 9. Lévy S, Chapet S, Scher N, Debbi K, Ruffier A, Bernadou G, Pointreau Y, Calais G. Reirradiation of gliomas under stereotactic conditions: Prognostic factors for survival without relapse or side effects, a retrospective study at Tours regional university hospital (France). Cancer Radiother. 2017 Dec;21(8) 759-765.
• 10. Dong Y, Fu C, Guan H et al. Re-irradiation alternatives for recurrent high-grade glioma. Oncology Lett. 12(4), 2261–2270 (2016).
• 11. Cho KH, Hall WA, Gerbi BJ, Higgins PD, McGuire WA, Clark HBC: Single dose versus fractionated stereotactic radiotherapy for recurrent high-grade gliomas. Int J Radiat Oncol Biol Phys 45(5): 1133–1141, 1999
• 12. Laing RW, Warrington AP, Graham J, Britton J, Hines F and Brada M. Efficacy and toxicity of fractionated stereotactic radiotherapy in the treatment of recurrent gliomas (phase I/II study). Radiotherapy Oncol 27: 22–29, 1993
• 13. Holt DE, Bernard ME, Quan K et al.Salvage sterotactic radiosurgery for recurrent glioblastoma multiforme with prior radiation therapy. J. Cancer Res. Ther. 12(4), 1243–1248 (2016).
• 14. Sutera PA, Bernard ME, Gill BS, Quan K, Engh JA, Burton SA, Heron DE. Salvage stereotactic radiosurgery for recurrent gliomas with prior radiation therapy.Future Oncol. 2017 Dec;13(29):2681-2690.
• 15. Sneed PK, Gutin PH, Larson DA, Malec MK, Phillips TL, Prados MD, Scharfen CO, Weaver KA, Wara WM: Patterns of recurrence of glioblastoma multiforme after external irradiation followed by implant boost. Int J Radiat Oncol Biol Phys 29: 719– 727, 1994.
• 16. Nieder C, Andratschke NH, Grosu AL. Re-irradiation for recurrent primary brain tumors. Anticancer Res. 36(10), 4985–4995 (2016).
• 17. Hasan S, Chen E, Lanciano R, et al. Salvage Fractionated Stereotactic Radiotherapy with or without Chemotherapy and Immunotherapy for Recurrent Glioblastoma Multiforme: A Single Institution Experience. Frontiers in Oncology. 2015;5:106. doi:10.3389/fonc.2015.00106.
• 18. Minniti G, Agolli L, Falco T, Scaringi C, Lanzetta G, Caporello P et al (2015) Hypofractionated stereotactic radiotherapy in combination with bevacizumab or fotemustine for patients with progressive malignant gliomas. J Neurooncol 122:559–566
• 19. Fogh SE, Andrews DW, Glass J, et al. Hypofractionated Stereotactic Radiation Therapy: An Effective Therapy for Recurrent High-Grade Gliomas. Journal of Clinical Oncology. 2010;28(18):3048-3053. doi:10.1200/JCO.2009.25.6941.
• 20. Veninga T, Langendijk HA, Slotman BJ, Rutten EH, van der Kogel AJ, Prick MJ, Keyser A, van der Maazen RW. Reirradiation of primary brain tumours: survival, clinical response and prognostic factors. Radiotherapy and Oncology , Volume 59 , Issue 2 , 127 – 137