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Stereotactic Radiosurgery Can Extend Survival in Small Recurrent Glioblastomas


Posted on: 06/23/2008

Stereotactic Radiosurgery Can Extend Survival in Small Recurrent Glioblastomas

 

NEW YORK JUN 19, 2008 (Reuters Health) - Stereotactic radiosurgery is safe and effective in selected patients with recurrent small-sized glioblastomas, according to a report in the May 1st issue of Cancer.

Repeat radiation for recurrent gliomas remains controversial because of possible radiation-induced necrosis, the authors explain, but some studies have suggested that stereotactic radiosurgery is effective, especially for glioblastoma.

Dr. Doo-Sik Kong and colleagues from Sungkyunkwan University School of Medicine in Seoul, South Korea, evaluated the efficacy of stereotactic radiosurgery as salvage treatment and its potential in prolonging survival time in 114 consecutive patients with recurrent grade 3 gliomas and glioblastomas.

The median overall survival after stereotactic radiosurgery was 26 months in patients with grade 3 gliomas and 13 months for those with glioblastomas, the authors report, resulting in a 1-year overall survival after stereotactic radiosurgery of 64.1% for grade 3 glioma and 58.4% for glioblastoma.

One-year progression-free survival was 20.5% for glioblastoma patients and 49.4% for grade 3 glioma patients, the report indicates, with median progression-free survival after stereotactic radiosurgery of 4.6 months for glioblastoma and 8.6 months for grade 3 glioma.

Compared with historical controls, the investigators say, stereotactic radiosurgery significantly prolonged survival in patients with recurrent glioblastoma, but not in patients with recurrent grade 3 glioma.

Complications of stereotactic radiosurgery, including nausea, vomiting, and headache, were usually controlled with steroid medications, the researchers note.

Twenty-two of 114 patients (24.4%) showed radiation necrosis on follow-up MRI scans.

"Stereotactic radiosurgery is a relatively safe treatment modality for patients with recurrent small-sized glioblastomas and can be efficiently used with acceptable morbidity in a highly selected patient population," the authors conclude. "The efficacy for recurrent grade 3 gliomas should be evaluated further in well-designed clinical studies."

 

SOURCE:

  • Cancer 2008;112:2046-2051.

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