Late Gamma Knife Surgery For Recurrent Malignant Glioma Who Iii iv

Ernest Dodoo1, Beate Huffmann2, Hanne Grinaker1, Inti Peredo1, Theofilus Machinis3, Marcus Olsson1, Michael Svensson1, Bodo Lippitz1

1Karolinska University Hospital, Stockholm, Sweden 2Aachen University Hospital 3Virginia Commonwealth University

Keywords: gamma knife, glioblastoma multiforme, outcome, anaplastic astrocytoma, radiosurgery

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     Early radiosurgical boost after conventional radiotherapy (EBRT) has shown to be ineffective while initial results demonstrate beneficial results after late Gamma knife surgery (GKS) of glioma recurrences.
     The current retrospective study assesses the efficacy of GKS in recurrences of malignant glioma .
     Between November 2001 and April 2009 a total of 74 consecutive patients with 87 WHO grade III + IV glioma had received standard treatment comprising microsurgery, EBRT, and chemotherapy at the Karolinska Hospital.
     All patients developed recurrences which were treated with GKS. Complete follow-up was available in all cases, median FU: 13.6 months (0.6 – 68.1 months). Median tumour volume 5.4 cc, prescription dose: 20 Gy (13-22 Gy), median max dose: 44 Gy (24 – 77 Gy).
     From initial diagnosis the WHO III patients showed a median survival of 48.7 months, 2-year survival of 84% and after the recurrence treated with GKS these patients survived a median of 22.7 months, 2-year survival of 40%. The WHO IV patients showed a median survival of 21.9 months, 2-year survival of 39% after diagnose and survived 10.4 months after the recurrence treated with GKS (2-year survival: 16%). 34% of all patients developed adverse radiation effects with clinical impact in 56% of these(14 patients).
     This is a retrospective study.
     These data present the results of late GKS in glioma recurrences with otherwise untreatable conditions showing a beneficial effect for the patients'''' survival.
     It must be emphasized that this is a different approach compared to earlier studies that failed to show a benefit after radiosurgery which was categorically timed in close relation and as boost to EBRT.


Project Roles:

E. Dodoo (), B. Huffmann (), H. Grinaker (), I. Peredo (), T. Machinis (), M. Olsson (), M. Svensson (), B. Lippitz ()