Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct;96(43):e8293.
doi: 10.1097/MD.0000000000008293.

Survival and complications of stereotactic radiosurgery: A systematic review of stereotactic radiosurgery for newly diagnosed and recurrent high-grade gliomas

Kaleigh Fetcko  1 , Rimas V Lukas, Gordon A Watson, Lingjiao Zhang, Mahua Dey
Affiliations

Survival and complications of stereotactic radiosurgery: A systematic review of stereotactic radiosurgery for newly diagnosed and recurrent high-grade gliomas

Kaleigh Fetcko et al. Medicine (Baltimore). 2017 Oct.

Abstract

Background: Utilization of stereotactic radiosurgery (SRS) for treatment of high-grade gliomas (HGGs) has been slowly increasing with variable reported success rates.

Objective: Systematic review of the available data to evaluate the efficacy of SRS as a treatment for HGG with regards to median overall survival (OS) and progression-free survival (PFS), in addition to ascertaining the rate of radiation necrosis and other SRS-related major neurological complications.

Methods: Literature searches were performed for publications from 1992 to 2016. The pooled estimates of median PFS and median OS were calculated as a weighted estimate of population medians. Meta-analyses of published rates of radiation necrosis and other major neurological complications were also performed.

Results: Twenty-nine studies reported the use of SRS for recurrent HGG, and 16 studies reported the use of SRS for newly diagnosed HGG. For recurrent HGG, the pooled estimates of median PFS and median OS were 5.42 months (3-16 months) and 20.19 months (9-65 months), respectively; the pooled radiation necrosis rate was 5.9% (0-44%); and the pooled estimates of major neurological complications rate was 3.3% (0-23%). For newly diagnosed HGG, the pooled estimates of median PFS and median OS were 7.89 months (5.5-11 months) and 16.87 months (9.5-33 months) respectively; the pooled radiation necrosis rate was 6.5% (0-33%); and the pooled estimates of other major neurological complications rate was 1.5% (0-25%).

Conclusion: Our results suggest that SRS holds promise as a relatively safe treatment option for HGG. In terms of efficacy at this time, there are inadequate data to support routine utilization of SRS as the standard of care for newly diagnosed or recurrent HGG. Further studies should be pursued to define more clearly the therapeutic role of SRS.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Funnel plots of (A) radiation necrosis rates for recurrent high-grade gliomas (HGGs), (B) other major neurological complications rates for recurrent HGG, (C) radiation necrosis rates for newly diagnosed HGG, and (D) other major neurological complications rates for newly diagnosed HGG.
Figure 2
Figure 2
Articles evaluated for inclusion in systematic review. n = number of articles, SRS = stereotactic radio surgery, HGG = high-grade glioma.
Figure 3
Figure 3
Forest plot of radiation necrosis rates for recurrent high-grade gliomas (HHGs).
Figure 4
Figure 4
Forrest plot of other major neurological complications rates for recurrent high-grade gliomas (HHGs).
Figure 5
Figure 5
Forest plot of radiation necrosis rates for newly diagnosed high-grade gliomas (HHGs).
Figure 6
Figure 6
Forest plot of other major neurological complication rates for newly diagnosed high-grade gliomas (HHGs).
See this image and copyright information in PMC

References

    1. Prisco FE, Weltman E, de Hanriot RM, et al. Radiosurgical boost for primary high-grade gliomas. J Neurooncol 2002;57:151–60. - PubMed
    1. Conde-Moreno AJ, Garcia-Gomez R, Albert-Antequera M, et al. Fractionated stereotactic radiotherapy plus bevacizumab after response to bevacizumab plus irinotecan as a rescue treatment for high-grade gliomas. Rep Pract Oncol Radiother 2015;20:231–8. - PMC - PubMed
    1. Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016;131:803–20. - PubMed
    1. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987–96. - PubMed
    1. Lukas RV, Mrugala MM. Pivotal therapeutic trials for infiltrating gliomas and how they affect clinical practice. Neuro Oncol Pract 2016;npw016–npw016. - PMC - PubMed

Publication types

MeSH terms