Gigliotti Michael J, Hasan Shaakir, Karlovits Stephen M, Ranjan Tulika, Wegner Rodney E
Division of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
Division of Medical Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, Pennsylvania, USA.
Stereotact Funct Neurosurg. 2018;96(5):289-295. doi: 10.1159/000493545. Epub 2018 Nov 7.
The aim of this study was to evaluate the efficacy of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) as salvage therapy for recurrent high-grade glioma and to look at the overall efficacy of treatment with linear accelerator (LINAC)-based radiosurgery and fractionated radiotherapy.
From 2010 to 2017, a total of 25 patients aged 23-74 years were re-irradiated with LINAC-based SRS and fSRT. Patients were treated to a median dose of 25 Gy in 5 fractions.
The median overall survival (OS) after (initial) diagnosis was 39 months with an actuarial 1-, 3-, and 5-year OS rate of 88, 56, and 30%, respectively. After treatment with SRS or fSRT, the median OS was 9 months with an actuarial 1-year OS rate of 29%. Local control, assessed for 28 tumors, after 6 months was 57%, while local control after 1 year was 39%. Three patients experienced local failure. There was no evidence of toxicity noted after SRS or fSRT throughout the follow-up period.
SRS and fSRT remain a safe, reasonable, effective treatment option for re-irradiation following recurrent glioblastoma. Additionally, treatment volume may predict local control in the salvage setting.
本研究旨在评估立体定向放射外科（SRS）和分次立体定向放射治疗（fSRT）作为复发性高级别胶质瘤挽救治疗的疗效，并观察基于直线加速器（LINAC）的放射外科和分次放射治疗的总体疗效。
2010年至2017年，共有25例年龄在23 - 74岁的患者接受了基于LINAC的SRS和fSRT再程放疗。患者接受的中位剂量为25 Gy，分5次给予。
（初次）诊断后的中位总生存期（OS）为39个月，精算1年、3年和5年OS率分别为88%、56%和30%。接受SRS或fSRT治疗后，中位OS为9个月，精算1年OS率为29%。对28个肿瘤进行评估，6个月时的局部控制率为57%，1年时为39%。3例患者出现局部复发。在整个随访期间，SRS或fSRT后均未发现毒性证据。
SRS和fSRT仍然是复发性胶质母细胞瘤再程放疗的一种安全、合理、有效的治疗选择。此外，治疗体积可能预测挽救治疗中的局部控制情况。
