Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA 22908, USA.
Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA 22908, USA.
Neurosurg Clin N Am. 2021 Jan;32(1):117-128. doi: 10.1016/j.nec.2020.08.007. Epub 2020 Nov 5.
Glioblastoma (GBM) is infiltrative neoplasm with limited treatment options and poor overall survival. Stereotactic radiosurgery (SRS) allows spatially precise and conformal delivery of high doses of radiation. Salvage SRS for locally recurrent GBM was shown to improve patient survival and have more favorable safety profile than repeated surgical resection. Boost SRS after fractionated radiation therapy is sometimes attempted; however, Radiation Therapy Oncology Group 93-05 randomized clinical trial did not demonstrate benefits of upfront SRS that was administered before fractionated radiation. Administration of bevacizumab with SRS is associated with improved survival and can allow SRS dose escalation.
胶质母细胞瘤(GBM)是一种浸润性肿瘤,治疗选择有限,总体生存率低。立体定向放射外科(SRS)允许精确的空间定位和高剂量的辐射适形输送。局部复发性 GBM 的挽救性 SRS 已被证明可以改善患者的生存,并具有比重复手术切除更有利的安全性。分次放疗后尝试进行 SRS 推量;然而,放射治疗肿瘤学组 93-05 随机临床试验并未显示在分次放疗前进行的 SRS 的优势。SRS 联合贝伐单抗治疗可改善生存,并可提高 SRS 剂量。