Long-term outcome data from 121 patients treated with Gamma knife stereotactic radiosurgery as salvage therapy for focally recurrent high-grade gliomas
Cody J. Smith, Marshall J. Fairres, Charlotte S. Myers, Kristina M. Chapple, Michal Klysik, John P. Karis, Emad Youssef and Kris A. Smith
Introduction: We examined patient outcomes after Gamma Knife stereotactic radiosurgery (GKSRS) salvage therapy for recurrent high-grade gliomas (HGGs) to determine whether tumor grade or lesion size affected overall survival (OS) and progression-free survival (PFS).
Methods: This single-center retrospective study assessed radiographic response and clinical outcomes following GKSRS salvage treatment of recurrent malignant gliomas (January 2005–March 2014).
Results: A total of 121 patients (67 female) with 132 tumors were treated. Median (range) PFS was 4.7 (3.9-5.4) months for the cohort, 6.8 (4.6-8.9) months for initial grade 2 tumors, 4.2 (1.9-6.5) months for initial grade 3 tumors, and 4.3 (3.7-4.9) months for initial grade 4 tumors. Patients with small lesions (≤6.7 cm3; n = 53) had significantly longer median (range) PFS (6.8 [4.8-8.8], P=0.02).
Conclusions: GKSRS offers meaningful salvage therapy with minimal morbidity in appropriately selected patients with focally recurrent HGGs.
Keywords: Gamma Knife; recurrent high-grade glioma; salvage therapy; stereotactic radiosurgery