Stereotactic radiosurgery for recurrent high-grade gliomas

Area of Science:

• Neuro-oncology
• Radiation Oncology
• Neurosurgery

Background:

• High-grade gliomas (WHO Grade III and IV) frequently recur, with limited standardized management options.
• Stereotactic radiosurgery (SRS) presents a non-invasive treatment approach for recurrent high-grade gliomas (rHGG).
• Further investigation into the efficacy of SRS for rHGG is warranted due to limited existing evidence.

Purpose of the Study:

• To evaluate the role and outcomes of stereotactic radiosurgery (SRS) in patients with recurrent high-grade gliomas (rHGG).
• To assess local and distant tumor control, overall survival (OS), and progression-free survival (PFS) following SRS for rHGG.

Main Methods:

• A retrospective cohort study included 33 patients with rHGG treated with Gamma Knife SRS between January 2020 and June 2024.
• Data collected included baseline demographics, radiosurgical parameters, outcomes, and toxicity.
• Survival analysis utilized Kaplan-Meier methods and Cox proportional hazard models.

Main Results:

• Overall local control rates at 3, 6, and 12 months were 69.9%, 45.9%, and 31.9%, respectively.
• Median OS from SRS was 7 months, and median PFS was 5.5 months.
• MGMT methylated status was significantly associated with improved OS (P=0.01).

Conclusions:

• SRS provides acceptable short-term local control for recurrent high-grade gliomas, particularly for patients unsuitable for surgery.
• Local failure is more prevalent than distant failure, highlighting the importance of global tumor control for PFS.
• MGMT methylation is a positive prognostic indicator for overall survival in rHGG patients treated with SRS.