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Rotating Gamma System Irradiation: A Promising Treatment for Low-grade Brainstem Gliomas
Pham Cam Phuong1, Nguyen Quang Hung2, Tran Bao Ngoc3
1The Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam phamcamphuong@gmail.com.
Aim:
To evaluate the role of rotating gamma system (RGS) radiosurgery for low-grade brainstem gliomas.
Patients And Methods:
Thirty-seven patients undergoing RGS radiosurgery at the Bach Mai Hospital Hanoi for low-grade brainstem glioma were included in this prospective interventional study. The median RGS dose was 12 Gy (range=8-16 Gy). Endpoints included response to RGS radiosurgery given as change in glioma size (maximum diameter), survival and adverse events. Follow-up was performed for 36 months. Three dose-groups (<13, 13-14 and >14 Gy) were compared for survival.
Results:
Mean glioma size decreased from 1.87 cm before RGS irradiation to 1.15 cm at 36 months. Mean survival was 39.5 months. Mean survival after <13, 13-14 and >14 Gy were 22.7, 66.7 and 49 months, respectively (p<0.05). Adverse events, mainly reduced appetite, sleep disturbances, headache and edema, were not associated with RGS dose and were easily managed.
Conclusion:
RGS radiosurgery led to promising results with acceptable toxicity in patients with low-grade brainstem gliomas.
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