Publication:
Salvage radiosurgery for selected patients with recurrent malignant gliomas.

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Date

2014-05-07

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Martínez-Carrillo, Miguel
Tovar-Martín, Isabel
Zurita-Herrera, Mercedes
Moral-Ávila, Rosario Del
Guerrero-Tejada, Rosario
Saura-Rojas, Enrique
Osorio-Ceballos, Juan Luis
Arrebola-Moreno, Juan Pedro
Expósito-Hernández, José

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Hindawi Publishing Corporation
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Abstract

Purpose. To analyse the survival after salvage radiosurgery and to identify prognostic factors. Methods. We retrospectively reviewed 87 consecutive patients, with recurrent high-grade glioma, that underwent stereotactic radiosurgery between 1997 and 2010. We evaluated the survival after initial diagnosis and after reirradiation. The prognostic factors were analysed by bivariate and multivariate Cox regression model. Results. The median age was 48 years old. The primary histology included anaplastic astrocytoma (47%) and glioblastoma (53%). A margin dose of 18 Gy was administered in the majority of cases (74%). The median survival after initial diagnosis was 21 months (39 months for anaplastic astrocytoma and 18.5 months for glioblastoma) and after reirradiation it was 10 months (17 months for anaplastic astrocytoma and 7.5 months for glioblastoma). In the bivariate analyses, the prognostic factors significantly associated with survival after reirradiation were age, tumour and treatment volume at recurrence, recursive partitioning analyses classification, Karnofsky performance score, histology, and margin to the planning target volume. Only the last four showed significant association in the multivariate analyses. Conclusion. stereotactic radiosurgery is a safe and may be an effective treatment option for selected patients diagnosed with recurrent high-grade glioma. The identified prognostic factors could help individualise the treatment.

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Journal Article;

MeSH Terms

Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Nervous System Neoplasms::Central Nervous System Neoplasms::Brain Neoplasms
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Germ Cell and Embryonal::Neuroectodermal Tumors::Neoplasms, Neuroepithelial::Glioma
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Neurosurgical Procedures::Stereotaxic Techniques::Radiosurgery
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Salvage Therapy
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Health Status Indicators::Severity of Illness Index::Karnofsky Performance Status

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Keywords

Neoplasias Encefálicas, Estudios de Seguimiento, Astrocitoma, Humanos, Radiocirugia, Terapia Recuperativa, Resultado del Tratamiento, Estado de Ejecución de Karnofsky, Procedimientos Quirúrgicos Mínimamente Invasivos

Citation

Martínez-Carrillo M, Tovar-Martín I, Zurita-Herrera M, Moral-Ávila R Del, Guerrero-Tejada R, Saura-Rojas E, et al. Salvage radiosurgery for selected patients with recurrent malignant gliomas. Biomed Res Int; 2014:657953