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. 2018 Dec;140(3):615-622.
doi: 10.1007/s11060-018-2988-0. Epub 2018 Sep 6.

Gamma knife radiosurgery for recurrent gliomas

Zjiwar H A Sadik  1   2   3 , Patrick E J Hanssens  4 , Jeroen B Verheul  4   5 , Guus N Beute  4   5 , Suan Te Lie  4   5 , Sieger Leenstra  6 , Hilko Ardon  4   5
Affiliations

Gamma knife radiosurgery for recurrent gliomas

Zjiwar H A Sadik et al. J Neurooncol. 2018 Dec.

Abstract

Objective: In recent years, gamma knife radiosurgery (GKRS) has become increasingly more popular as a salvage treatment modality for patients diagnosed with recurrent gliomas. The goal of GKRS for recurrent glioma patients is to improve survival rates with minimal burden for these patients. The emphasis of this report is on local tumor control (TC), clinical outcome and survival analysis.

Methods: We performed a retrospective analysis of prospectively collected data of all patients who underwent GKRS for gliomas at the Gamma Knife Center Tilburg between 23-09-2002 and 21-05-2015. In total, 94 patients with glioma were treated with GKRS. Two patients were excluded because GKRS was used as a first stage treatment. The other 92 patients were included for analysis.

Results: TC was 37% for all tumors (TC was 50% in LGGs and 27% in HGGs). Local progression (LP) was 46% for all tumors (LP was 31% in LGGs and 58% in HGGs). New distant lesions were seen in 18% of all patients (in 5% of LGG patients and 31% of HGG patients). Median progression-free and overall survival (PFS and OS) for all patients were 10.5 and 34.4 months, respectively. Median PFS was 50.1 and 5.7 months for low and high grade tumors, respectively. Median OS was 86.6 and 12.8 months for low and high grade tumors, respectively. No serious adverse events were noted post-GKRS.

Conclusion: GKRS can safely be used as salvage treatment for recurrent glioma and seems to improve survival rates in (high grade) glioma patients with minimal burden.

Keywords: Gamma knife radiosurgery; Gliomas; Recurrent.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Tilburg radiological classification
Fig. 2
Fig. 2
Progression-free and overall survival (PFS and OS) for all patients and according to tumor grade (LGG vs. HGG). Median PFS was 10.5 months (range 0.4–139.4 months) and median OS was 34.4 months (range 0.5–139.4 months). (mo months). Low grade tumors were defined as grade 1 and 2 tumors, high grade tumors as grade 3 and 4 tumors. Median PFS was 50.1 months (range 1.3–139.4 months) and 5.7 months (range 0.4–92.5 months) for low and high grade tumors respectively. Median OS was 86.6 months (range 1.3–139.4 months) and 12.8 months (range 0.5–109.5 months) for low and high grade tumors respectively. (mo months, vs versus)
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