Clinical outcomes following salvage Gamma Knife radiosurgery for recurrent glioblastoma

来源 :World Journal of Clinical Oncology | 被引量 : 0次 | 上传用户:whzjs
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Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed. Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo ​​for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in about six months. Salvage therapy options for This study compares recent survival and quality of life risk following the Gamma Knife radiosurgery (GKRS) salvage therapy. Following a Pub Med search for studies using GKRS as salvage therapy for malignant gliomas, nine articles from this 2005 to July 2013 were identified this evaluated rG BM treatment. follow this diagnosis, we compare overall survival following the diagnosis, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report have results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studie s reported median overall survival rates (from diagnosis, range: 16.7-33.2 mo; from salvage, range: 9-17.9 mo). Three showed identified median progression-free survival Six studies reported adverse radiation effects (range: 0% -46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the selection of can bias be dismissed.
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