复发性胶质母细胞瘤患者接受伽马刀低分次放射治疗后疗效显著。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2024-01-10 DOI:10.1016/j.neuchi.2024.101532

Mustafa Aziz Hatiboglu , Kerime Akdur , Ayten Sakarcan , Mehmet Hakan Seyithanoglu , Haci Mehmet Turk , Georges Sinclair , Mustafa Namik Oztanir

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引用次数: 0

摘要

背景：伽玛刀放射外科手术（GKRS）在复发性胶质母细胞瘤中的作用仍不明确。本研究的目的是评估伽马刀放射外科治疗对复发性胶质母细胞瘤患者的影响，重点关注生存率和安全性：本研究纳入了2014年9月至2019年4月期间接受GKRS治疗的复发性胶质母细胞瘤患者。记录并分析相关临床和放射外科数据，包括 GKRS 相关并发症。对总生存期（OS）、局部无进展生存期（LPFS）和预后因素进行了全面评估：结果：共分析了 53 例患者（女性 24 例，男性 29 例）。中位年龄为 50 岁（19-78 岁）。中位 GKRS 治疗量为 35.01 立方厘米（范围为 2.38-115.57 立方厘米）。20名患者（38%）接受了单剂量GKRS治疗，33名患者（62%）接受了基于GKRS的低分次立体定向放射治疗（HSRT）。单次分次GKRS、3次分次HSRT和5次分次HSRT的中位处方剂量分别为16 Gy（范围为10-20 Gy）、27 Gy（范围为18-33 Gy）和25 Gy（范围为25-30 Gy）。GKRS后的中位LPFS和OS时间分别为8.1个月和11.4个月。HSRT和贝伐单抗与LPFS的改善有关，而单用HSRT与OS的延长有关：我们的研究结果表明，在明确的情况下，HRST可能会改善LPFS和OS；在GKRS中加入贝伐珠单抗可提高局部控制率。没有重大并发症的报道。我们需要进一步的前瞻性研究来证实我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Promising outcome of patients with recurrent glioblastoma after Gamma Knife-based hypofractionated radiotherapy

Background

The role of Gamma Knife radiosurgery (GKRS) in recurrent glioblastoma remains unclear. The purpose of this study is to evaluate the effects of GKRS in a group of patients with recurrent glioblastoma, focusing on survival and safety.

Methods

Patients undergoing GKRS for recurrent glioblastoma between September 2014 and April 2019 were included in this study. Relevant clinical and radiosurgical data, including GKRS-related complications, were recorded and analyzed. Overall survival (OS), local progression free survival (LPFS) and prognostic factors for outcome were thoroughly evaluated.

Results

Fifty-three patients were analyzed (24 female, 29 male). The median age was 50 years (range, 19–78 years). The median GKRS treatment volume was 35.01 cm³ (range, 2.38-115.57 cm³). Twenty patients (38%) were treated with single fraction GKRS, while 33 (62%) were treated with GKRS-based hypofractionated stereotactic radiotherapy (HSRT). The median prescription dose for single fraction GKRS, 3-fractions HSRT and 5-fractions HSRT were 16 Gy (range, 10−20 Gy), 27 Gy (range, 18−33 Gy) and 25 Gy (range, 25−30 Gy), respectively. The median LPFS and OS times were 8.1 months and 11.4 months after GKRS, respectively. HSRT and Bevacizumab were associated with improved LPFS, while HSRT alone was associated with longer OS.

Conclusion

Our findings suggested that HRST would likely improve LPFS and OS in definite settings; the addition of Bevacizumab to GKRS was associated with increased rates of local control. No major complications were reported. Further prospective studies are warranted to confirm our findings.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.