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Related Experiment Videos

Radiosurgery for primary malignant brain tumors

E Alexander1, J S Loeffler

  • 1Brain Tumor Center, Brigham and Women's Hospital, Boston, Massachusetts 02115-6195, USA. ealexand@earthlink.net or ealexand@bwh.harvard.edu

Seminars in Surgical Oncology
|January 4, 1998
PubMed
Summary

Stereotactic radiosurgery (SRS) offers improved survival for glioblastoma multiforme (GBM) patients by precisely targeting tumors. While complications like edema can occur, SRS provides a significant survival advantage, especially for smaller, distinct recurrences.

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Oncology

Background:

  • Glioblastoma multiforme (GBM) remains a lethal brain tumor despite standard treatments like surgery, radiotherapy, and chemotherapy.
  • Local tumor persistence or recurrence is the primary cause of mortality in GBM patients.
  • Existing therapies have limitations in eradicating the disease effectively.

Purpose of the Study:

  • To evaluate the efficacy and safety of Stereotactic Radiosurgery (SRS) for glioblastoma multiforme (GBM).
  • To determine the impact of SRS on patient survival and recurrence patterns.
  • To identify patient and tumor characteristics that predict successful outcomes with SRS.

Main Methods:

  • Utilized Stereotactic Radiosurgery (SRS), a technique delivering a high radiation dose focally to small targets.

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  • Analyzed patient data focusing on survival rates, complication profiles, and reoperation risks post-SRS.
  • Compared treatment failure patterns between SRS and brachytherapy for recurrent GBM.

    • Main Results:

    • SRS demonstrated a significant survival advantage in patients with gliomas, particularly when used adjunctively.
    • Acute complications, primarily edema-related, were transient and manageable with steroids.
    • The risk of reoperation was 33% at 12 months and 48% at 24 months post-SRS.
    • Patterns of failure were similar to brachytherapy, with marginal recurrence outside the treatment volume.

    Conclusions:

    • SRS is a viable option for select patients with small (<30 mm), distinct, focally recurrent GBM.
    • Larger lesions or those near critical brain structures require cautious evaluation due to increased toxicity risks.
    • SRS, when appropriately integrated with surgery and adjuvant therapies, offers a significant survival benefit for glioma patients.