[Not Available]

Area of Science:

• Neuro-oncology
• Radiation Oncology
• Medical Physics

Background:

• High-grade gliomas (HGGs) often recur locally, necessitating effective salvage therapies.
• Reirradiation presents a challenge due to cumulative dose constraints and potential toxicity.
• CyberKnife (CK) offers precise, fractionated stereotactic radiosurgery for targeted tumor treatment.

Purpose of the Study:

• To evaluate the efficacy and safety of fractionated stereotactic reirradiation with CK in patients with recurrent high-grade gliomas.
• To assess progression-free survival (PFS) and overall survival (OS) after CK reirradiation.
• To explore the potential for improved patient outcomes through earlier detection of local recurrence (LR).

Main Methods:

• Retrospective analysis of 6 patients with multiform grade IV gliomas experiencing local recurrence (LR).
• Reirradiation performed using CyberKnife (CK) with either 36 Gy in 6 fractions or 30 Gy in 3 fractions.
• Data collected on time to LR, PFS after CK, OS after CK, and OS after initial diagnosis.

Main Results:

• Median time to LR from primary radiotherapy was 14.1 months.
• Median PFS after CK was 3.4 months (5 cases).
• Median OS after CK was 12 months (3 cases), and median OS after initial diagnosis was 37 months (3 cases).
• No toxicity was observed in 4 assessed cases.
• Time to first progression after primary treatment strongly predicted survival.

Conclusions:

• Fractionated stereotactic reirradiation with CK is a well-tolerated and effective salvage option for patients with recurrent high-grade gliomas.
• Early identification of LR through regular MRI follow-up (every 3 months) is recommended.
• CK reirradiation offers a viable option to improve survival chances for patients with recurrent HGGs.