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Media type:
E-Article
Title:
Gamma Knife Radiosurgery in Recurrent Glioblastoma
Contributor:
Frischer, Josa M.;
Marosi, Christine;
Woehrer, Adelheid;
Hainfellner, Johannes A.;
Dieckmann, Karin Ute;
Eiter, Helmut;
Wang, Wei-Te;
Mallouhi, Ammar;
Ertl, Adolf;
Knosp, Engelbert;
Filipits, Martin;
Kitz, Klaus;
Gatterbauer, Brigitte
Published:
S. Karger AG, 2016
Published in:
Stereotactic and Functional Neurosurgery, 94 (2016) 4, Seite 265-272
Language:
English
DOI:
10.1159/000448924
ISSN:
1011-6125;
1423-0372
Origination:
Footnote:
Description:
<b><i>Background:</i></b> We evaluated Gamma Knife radiosurgery (GKRS) as a treatment option for patients with recurrent glioblastoma. <b><i>Patients and Methods:</i></b> 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<sup>3</sup>. The median margin dose was 10 Gy and the median central dose 20 Gy. In a subset of patients, O<sup>6</sup>-methylguanine methyltransferase (MGMT) promoter methylation analysis by pyrosequencing was performed. <b><i>Results:</i></b> 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). <b><i>Conclusion:</i></b> 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.