PURPOSE: To determine the radiographic and clinical efficacy of stereotactic single dose radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) as salvage therapy for glioblastoma (GBM) at recurrence. METHODS: Thirty-six patients with pathologically proven recurrent GBM were treated with salvage reirradiation by either SRS or FSRT between March of 2001 and August of 2006. Thirty-one patients had an initial diagnosis of GBM. Five patients had a malignant transformation. All patients had received radiotherapy with a dose of 50-60 Gy, a median 13.6 months prior to reirradiation (range: 0.8-119 months). At the time of recurrence, 26 patients were treated with SRS with a median dose of 18 Gy (range: 12-20 Gy). FSRT was performed in ten patients with a dose of 36 Gy in six fractions, twice weekly. Follow-up included MRI and clinical examination every 2 months. RESULTS: Median survival time after SRS was 8.5 months, compared to 7.4 months after FSRT (P = 0.81). Of 26 patients treated with SRS, radiographic tumor response or stable disease was observed in eight (35%) patients and tumor progression was seen in 18 (65%) patients. Of 10 patients treated by FSRT, radiographic tumor response or stable disease was observed in four (40%) patients and tumor progression was observed in four (40%) patients (two lost to follow-up). Patients who responded to treatment had statistically improved survival compared to non-responders, with median survival of 15.8 vs. 7.3 months (P < 0.05). CONCLUSION: Salvage reirradiation with SRS or FSRT for recurrent GBM results in radiographic response in a proportion of patients. Survival was significantly improved among patients who either responded or had stable disease after salvage reirradiation, compared to non-responders. Further study is warranted to investigate the method and time of reirradiation for recurrent GBM.
PURPOSE: To determine the radiographic and clinical efficacy of stereotactic single dose radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) as salvage therapy for glioblastoma (GBM) at recurrence. METHODS: Thirty-six patients with pathologically proven recurrent GBM were treated with salvage reirradiation by either SRS or FSRT between March of 2001 and August of 2006. Thirty-one patients had an initial diagnosis of GBM. Five patients had a malignant transformation. All patients had received radiotherapy with a dose of 50-60 Gy, a median 13.6 months prior to reirradiation (range: 0.8-119 months). At the time of recurrence, 26 patients were treated with SRS with a median dose of 18 Gy (range: 12-20 Gy). FSRT was performed in ten patients with a dose of 36 Gy in six fractions, twice weekly. Follow-up included MRI and clinical examination every 2 months. RESULTS: Median survival time after SRS was 8.5 months, compared to 7.4 months after FSRT (P = 0.81). Of 26 patients treated with SRS, radiographic tumor response or stable disease was observed in eight (35%) patients and tumor progression was seen in 18 (65%) patients. Of 10 patients treated by FSRT, radiographic tumor response or stable disease was observed in four (40%) patients and tumor progression was observed in four (40%) patients (two lost to follow-up). Patients who responded to treatment had statistically improved survival compared to non-responders, with median survival of 15.8 vs. 7.3 months (P < 0.05). CONCLUSION: Salvage reirradiation with SRS or FSRT for recurrent GBM results in radiographic response in a proportion of patients. Survival was significantly improved among patients who either responded or had stable disease after salvage reirradiation, compared to non-responders. Further study is warranted to investigate the method and time of reirradiation for recurrent GBM.
Authors: Robert A Lustig; Wendy Seiferheld; Brian Berkey; Alfred W K Yung; Charles Scarantino; Benjamin Movsas; Christopher U Jones; Joseph R Simpson; Jennifer Fishbach; Walter J Curran Journal: Am J Clin Oncol Date: 2007-02 Impact factor: 2.339
Authors: Rajan Jain; Lisa Scarpace; Shehanaz Ellika; Lonni R Schultz; Jack P Rock; Mark L Rosenblum; Suresh C Patel; Ting-Yim Lee; Tom Mikkelsen Journal: Neurosurgery Date: 2007-10 Impact factor: 4.654
Authors: James J Vredenburgh; Annick Desjardins; James E Herndon; Jennifer Marcello; David A Reardon; Jennifer A Quinn; Jeremy N Rich; Sith Sathornsumetee; Sridharan Gururangan; John Sampson; Melissa Wagner; Leighann Bailey; Darell D Bigner; Allan H Friedman; Henry S Friedman Journal: J Clin Oncol Date: 2007-10-20 Impact factor: 44.544
Authors: A D Norden; G S Young; K Setayesh; A Muzikansky; R Klufas; G L Ross; A S Ciampa; L G Ebbeling; B Levy; J Drappatz; S Kesari; P Y Wen Journal: Neurology Date: 2008-03-04 Impact factor: 9.910
Authors: Dirk Vordermark; Oliver Kölbl; Klemens Ruprecht; Giles H Vince; Klaus Bratengeier; Michael Flentje Journal: BMC Cancer Date: 2005-05-30 Impact factor: 4.430
Authors: Eun Young Kim; Raphael Yechieli; Jin Koo Kim; Tom Mikkelsen; Steven N Kalkanis; Jack Rock; Mark Rosenblum; Samuel Ryu Journal: J Neurooncol Date: 2013-10-31 Impact factor: 4.130
Authors: Grant M Clark; Andrew M McDonald; Louis B Nabors; Hassan Fathalla-Shaykh; Xiaosi Han; Christopher D Willey; James M Markert; Barton L Guthrie; Markus Bredel; John B Fiveash Journal: Neurooncol Pract Date: 2014-12
Authors: Roy G Torcuator; Ravneet Thind; Mehul Patel; Y S Mohan; Joseph Anderson; Thomas Doyle; Samuel Ryu; Rajan Jain; Lonni Schultz; Mark Rosenblum; Tom Mikkelsen Journal: J Neurooncol Date: 2009-10-17 Impact factor: 4.130