Efficacy Of Gamma Knife Radiosurgery In Recurrent Oligodendrogliomas

Yeob Seung Yang1, Dong Gyu Kim2

1DongGuk University College of Medicine 2 Seoul National University Hospital

Keywords: oligodendroglioma, brain tumor, gamma knife, outcome, recurrent disease

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     To evaluate the efficacy of stereotactic Gamma knife radiosurgery (GKRS) performed as an adjuvant treatment in 35 patients with recurrent low- and high-grade oligodendrogliomas.
     Between December 1997 and April 2009, 35 patients with recurrent low- and high-grade oligodendrogliomas (12 Grade II and 23 Grade III) were treated using GKRS in a single institution. The mean patient age was 43.4 years (range, 11-71).
     Of these 35 patients, 28 received a full course of radiotherapy after primary diagnosis with a median dose of 55.4Gy in conventional fractionation and 12 received at least one chemotherapeutic regimen including procarbazine, cyclophosphamide, and vincristine (PCV). The mean time between microsurgery and GKRS was 60.9 months (range, 4.1-146.0). The mean target volume was 5.10 cm3 (range, 0.04-25.60) and the mean margin dose was 16.2Gy (range, 10-23).
     At a mean of 54.1 months of follow-up (range, 6.8-141.0) after GKRS, 18 patients were dead and 17 were living. Mean overall survival after primary diagnosis was 162.8 months for patients with oligodendroglioma and 89.5 months for patients with anaplastic oligodendroglioma. Mean survival after GKRS was 119.7 months for patients with oligodendroglioma and 50.3 months for patients with anaplastic oligodendroglioma. Postradiosurgical chemotherapy and histology were significant in influencing survival after GKRS. Mean progression-free survival after GKRS was 71.5 months for oligodendroglioma and 26.3 months for anaplastic oligodendroglioma. Factor associated with an improved progression-free survival was histology. At tumor progression after FSRT, tumor resection was conducted in 13 patients and chemotherapy was performed in 11 patients, including the administration of temozolomide, bevacizumab, irinotecan, or PCV, taking into consideration prior systemic treatments.
     This is a retrospective study.
     GKRS offers considerable treatment option as a salvage therapy for a subgroup of patients with smaller lesions of recurrent oligodendrogliomas.


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Y. Yang (), D. Kim ()