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Updated: Feb 15, 2026

Stereotactic Radiosurgery for Gynecologic Cancer
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Stereotactic Radiosurgery for Gynecologic Cancer

Published on: April 17, 2012

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Stereotactic Radiosurgery in the Multimodality Management of Residual or Recurrent Glioblastoma Multiforme

Ajay Niranjan, Edward A Monaco, Hideyuki Kano

    Progress in Neurological Surgery
    |February 3, 2018
    PubMed

    Insights

    Stereotactic radiosurgery (SRS) offers improved survival for recurrent glioblastoma multiforme (GBM) patients. Factors like tumor volume and patient age impact outcomes, with combination therapy showing promise.

    Area of Science:

    • Neurosurgery
    • Radiation Oncology
    • Oncology

    Background:

    • Management options for recurrent or residual glioblastoma multiforme (GBM) are limited.
    • Stereotactic radiosurgery (SRS) is an underutilized yet potentially beneficial treatment for malignant gliomas.

    Purpose of the Study:

    • To evaluate the efficacy and outcomes of Gamma Knife surgery (GKS) for residual or recurrent GBM.
    • To identify prognostic factors influencing survival after SRS in GBM patients.

    Main Methods:

    • Retrospective analysis of 297 patients with histologically proven residual or recurrent GBM treated with GKS over 20 years.
    • Utilized modified Recursive Partitioning Analysis (RPA) classification for outcome comparison.
    • Analyzed prognostic variables including tumor volume, radiation dose, and patient age.

    Main Results:

    • Median survival after initial diagnosis was 18 months; median survival from SRS was 9 months.
    • 1- and 2-year survival rates were 72.5% and 29.5%, respectively.
    • Favorable prognostic factors: tumor volume <14 cm3, marginal radiation dose ≥15 Gy, age <60 years. Adverse radiation effects (ARE) in 23% managed with corticosteroids.
    • Combination of SRS with bevacizumab improved survival and reduced ARE.

    Conclusions:

    • SRS, particularly Gamma Knife surgery, can improve survival in select patients with residual or recurrent GBM.
    • Modified RPA and specific prognostic factors can predict outcomes.
    • Further evaluation in prospective controlled trials is essential to confirm SRS efficacy in GBM management.

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