Clinical outcomes of gamma knife radiosurgery in the salvage treatment of patients with recurrent high-grade glioma.

Autor: Elaimy AL; Department of Neurosurgery, Gamma Knife of Spokane, University of Washington School of Medicine, Spokane, Washington, USA; Department of Radiation Oncology, Gamma Knife of Spokane and Cancer Care Northwest, University of Washington School of Medicine, Spokane, Washington, USA., Mackay AR, Lamoreaux WT, Demakas JJ, Fairbanks RK, Cooke BS, Lamm AF, Lee CM
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2013 Dec; Vol. 80 (6), pp. 872-8. Date of Electronic Publication: 2013 Feb 09.
DOI: 10.1016/j.wneu.2013.02.030
Abstrakt: Background: Previously published randomized evidence did not report a survival advantage for patients diagnosed with grade IV glioma who were treated with stereotactic radiosurgery followed by external beam radiation therapy and chemotherapy when compared to patients treated with external beam radiation therapy and chemotherapy alone. In recent years, gamma knife radiosurgery has become increasingly popular as a salvage treatment modality for patients diagnosed with recurrent high-grade glioma. The purpose of this article is to review the efficacy of gamma knife radiosurgery for patients who suffer from this malignancy.
Methods: Retrospective, prospective, and randomized clinical studies published between the years 2000 and 2012 analyzing gamma knife radiosurgery for patients with high-grade glioma were reviewed.
Results: After assessing patient age, Karnofsky performance status, tumor histology, and extent of resection, gamma knife radiosurgery is a viable, minimally invasive treatment option for patients diagnosed with recurrent high-grade glioma. The available prospective and retrospective evidence suggests that gamma knife radiosurgery provides patients with a high local tumor control rate and a median survival after tumor recurrence ranging from 13 to 26 months. Gamma knife radiosurgery followed by chemotherapy for recurrent high-grade glioma may provide select patients with increased levels of survival. However, further investigation into this matter is needed due to the limited number of published reports. Additional clinical research is also needed to analyze the efficacy and radiation-related toxicities of fractionated gamma knife radiosurgery due to its potential to limit treatment-associated morbidity.
Conclusions: Gamma knife radiosurgery is a safe and effective treatment option for select patients diagnosed with recurrent high-grade glioma. Although treatment outcomes have improved, further evidence in the form of phase III randomized trials is needed to assess the durability of treating patients in specific clinical situations.
(Copyright © 2013 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: