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Promising outcome of patients with recurrent glioblastoma after Gamma Knife-based hypofractionated radiotherapy

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2024-03-01

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HATİBOĞLU M. A.
Akdur K.
Sakarcan A.
SEYİTHANOĞLU M. H.
TÜRK H. M.
Sinclair G.
ÖZTANIR M. N.

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Abstract

Background: The role of Gamma Knife radiosurgery (GKRS) in recurrent glioblastoma remains unclear. The purpose of this study is to evaluate the effects of GKRS in a group of patients with recurrent glioblastoma, focusing on survival and safety. Methods: Patients undergoing GKRS for recurrent glioblastoma between September 2014 and April 2019 were included in this study. Relevant clinical and radiosurgical data, including GKRS-related complications, were recorded and analyzed. Overall survival (OS), local progression free survival (LPFS) and prognostic factors for outcome were thoroughly evaluated. Results: Fifty-three patients were analyzed (24 female, 29 male). The median age was 50 years (range, 19–78 years). The median GKRS treatment volume was 35.01 cm3 (range, 2.38-115.57 cm3). Twenty patients (38%) were treated with single fraction GKRS, while 33 (62%) were treated with GKRS-based hypofractionated stereotactic radiotherapy (HSRT). The median prescription dose for single fraction GKRS, 3-fractions HSRT and 5-fractions HSRT were 16 Gy (range, 10−20 Gy), 27 Gy (range, 18−33 Gy) and 25 Gy (range, 25−30 Gy), respectively. The median LPFS and OS times were 8.1 months and 11.4 months after GKRS, respectively. HSRT and Bevacizumab were associated with improved LPFS, while HSRT alone was associated with longer OS. Conclusion: Our findings suggested that HRST would likely improve LPFS and OS in definite settings; the addition of Bevacizumab to GKRS was associated with increased rates of local control. No major complications were reported. Further prospective studies are warranted to confirm our findings.

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Tıp, Dahili Tıp Bilimleri, Nöroloji, Cerrahi Tıp Bilimleri, Sağlık Bilimleri, Medicine, Internal Medicine Sciences, Neurology, Surgery Medicine Sciences, Health Sciences, Klinik Tıp (MED), Klinik Tıp, CERRAHİ, KLİNİK NÖROLOJİ, Clinical Medicine (MED), CLINICAL MEDICINE, SURGERY, CLINICAL NEUROLOGY, Cerrahi, Nöroloji (klinik), Surgery, Neurology (clinical), Bevacizumab, Gamma Knife radiosurgery, Glioblastoma, Hypofractionation

Citation

HATİBOĞLU M. A., Akdur K., Sakarcan A., SEYİTHANOĞLU M. H., TÜRK H. M., Sinclair G., ÖZTANIR M. N., "Promising outcome of patients with recurrent glioblastoma after Gamma Knife-based hypofractionated radiotherapy", Neurochirurgie, cilt.70, sa.2, 2024
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