Gamma knife radiosurgery for high grade glial neoplasms: a Canadian experience

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• High-grade gliomas (WHO grades III and IV) are aggressive brain tumors.
• Recurrence of these tumors presents significant treatment challenges.
• Focal recurrence requires precise and effective therapeutic strategies.

Purpose of the Study:

• To evaluate the institutional experience using Gamma Knife (GK) stereotactic radiosurgery (SRS).
• To assess the efficacy and safety of GK SRS for treating focally recurrent high-grade gliomas.
• To analyze survival outcomes and complications in this patient cohort.

Main Methods:

• Retrospective cohort review of patients treated with GK SRS for recurrent high-grade gliomas (November 2003 - April 2013).
• Data collected included patient demographics, tumor characteristics (volume, location, diameter), clinical status, complications, and outcomes.
• Survival analysis was performed post-GK treatment.

Main Results:

• 33 patients were identified; 4 were lost to follow-up.
• Average post-GK survival was 20.4 months; overall survival was 63.3 months.
• WHO grade IV gliomas showed average post-GK survival of 15.8 months and overall survival of 40.1 months.
• WHO grade III gliomas showed average post-GK survival of 34.9 months and overall survival of 136.4 months.
• Post-GK edema occurred in 75.9% of patients; radiation necrosis in 13.8%.

Conclusions:

• Gamma Knife SRS provides extended local tumor control for selected patients with recurrent high-grade gliomas.
• The treatment is associated with acceptable morbidity.
• GK SRS may offer potentially prolonged survival in carefully selected cases.