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[Not Available].

P Nickers, B Frederick, C Louis

    Bulletin De La Societe Des Sciences Medicales Du Grand-Duche De Luxembourg
    |June 6, 2018
    PubMed
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    Fractionated stereotactic reirradiation using CyberKnife (CK) shows efficacy in treating high-grade gliomas with local recurrence (LR). This treatment is well-tolerated and improves survival, suggesting a new MRI follow-up paradigm for earlier detection and salvage options.

    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).

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  • 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.