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Stereotactic radiosurgery for recurrent malignant gliomas

W A Hall¹, H R Djalilian, P W Sperduto

¹Department of Neurosurgery, University of Minnesota Hospital and Clinic, Minneapolis 55455, USA.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology

|July 1, 1995

Summary

Stereotactic radiosurgery may extend survival for patients with recurrent malignant gliomas. This treatment shows a lower reoperation rate for necrosis compared to brachytherapy.

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Area of Science:

Neurosurgery
Radiation Oncology
Oncology

Background:

Recurrent malignant gliomas pose a significant challenge in neuro-oncology.
Conventional treatments often have limited efficacy for recurrent disease.

Purpose of the Study:

To evaluate the efficacy of stereotactic radiosurgery (SRS) in managing recurrent malignant gliomas.
To assess survival outcomes and patterns of failure following SRS.

Main Methods:

SRS was administered to 35 patients with large recurrent gliomas (median volume 28 cm³).
Patients included 26 glioblastomas multiforme (GBM) and 9 anaplastic astrocytomas (AA).
Survival and reoperation rates were analyzed.

Main Results:

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The median survival from diagnosis was 21 months and from radiosurgery was 8 months.
Age and Karnofsky Performance Status (KPS) were associated with improved survival.
The actuarial necrosis rate was 14%, with a 31% reoperation rate for mass effect.

Conclusions:

Stereotactic radiosurgery appears to prolong survival in recurrent malignant gliomas.
SRS demonstrates a lower reoperative rate for necrosis compared to brachytherapy.
Patterns of failure are comparable between SRS and brachytherapy.