Journal of Korean Neurosurgical Society

  • 제61권4호
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  • Pages.516-524
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  • 2018
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Efficacy of Gamma Knife Radiosurgery for Recurrent High-Grade Gliomas with Limited Tumor Volume

  • Cheon, Young-Jun (Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine) ;
  • Jung, Tae-Young (Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine) ;
  • Jung, Shin (Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine) ;
  • Kim, In-Young (Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine) ;
  • Moon, Kyung-Sub (Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine) ;
  • Lim, Sa-Hoe (Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine)
  • 투고 : 2017.09.28
  • 심사 : 2018.01.01
  • 발행 : 2018.07.01
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초록

Objective : This study aims to determine whether gamma knife radiosurgery (GKR) improves survival in patients with recurrent high-grade gliomas. Methods : Twenty nine patients with recurrent high-grade glioma underwent 38 GKR. The male-to-female ratio was 10 : 19, and the median age was 53.8 years (range, 20-75). GKR was performed in 11 cases of recurrent anaplastic oligodendrogliomas, five anaplastic astrocytomas, and 22 glioblastomas. The median prescription dose was 16 Gy (range, 10-24), and the median target volume was 7.0 mL (range, 1.1-15.7). Of the 29 patients, 13 (44.8%) received concurrent chemotherapy. We retrospectively analyzed the progression-free survival (PFS) and overall survival (OS) after GKR depending on the Eastern Cooperative Oncology Group (ECOG) performance status (PS), pathology, concurrent chemotherapy, radiation dose, and target tumor volume. Results : Starting from when the patients underwent GKR, the median PFS and OS were 5.0 months (range, 1.1-28.1) and 13.0 months (range, 1.1-75.1), respectively. On univariate analysis, the median PFS was significantly long in patients with anaplastic oligodendroglioma, ECOG PS 1, and target tumor volume less than 10 mL (p<0.05). Meanwhile, on multivariate analysis, patients with ECOG PS 1 and target tumor volume less than 10 mL showed improved PFS (p=0.043 and p=0.007, respectively). The median OS was significantly increased in patients with ECOG PS 1 and tumor volume less than 10 mL on univariate and multivariate analyses (p<0.05). Conclusion : GKR could be an additional treatment option in recurrent high-grade glioma, particularly in patients with good PS and limited tumor volume.

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참고문헌

  1. Bokstein F, Blumenthal DT, Corn BW, Gez E, Matceyevsky D, Shtraus N, et al. : Stereotactic radiosurgery (SRS) in high-grade glioma: judicious selection of small target volumes improves results. J Neurooncol 126 : 551-557, 2016 https://doi.org/10.1007/s11060-015-1997-5
  2. Combs SE, Debus J, Schulz-Ertner D : Radiotherapeutic alternatives for previously irradiated recurrent gliomas. BMC Cancer 7 : 167, 2007 https://doi.org/10.1186/1471-2407-7-167
  3. Conti A, Pontoriero A, Arpa D, Siragusa C, Tomasello C, Romanelli P, et al. : Efficacy and toxicity of CyberKnife re-irradiation and "dose dense" temozolomide for recurrent gliomas. Acta Neurochir (Wien) 154 : 203- 209, 2012 https://doi.org/10.1007/s00701-011-1184-1
  4. Dodoo E, Huffmann B, Peredo I, Grinaker H, Sinclair G, Machinis T, et al. : Increased survival using delayed gamma knife radiosurgery for recurrent high-grade glioma: a feasibility study. World Neurosurg 82 : e623-e632, 2014 https://doi.org/10.1016/j.wneu.2014.06.011
  5. Dong Y, Fu C, Guan H, Zhang T, Zhang Z, Zhou T, et al. : Re-irradiation alternatives for recurrent high-grade glioma. Oncol Lett 12 : 2261-2270, 2016 https://doi.org/10.3892/ol.2016.4926
  6. Ernst-Stecken A, Ganslandt O, Lambrecht U, Sauer R, Grabenbauer G : Survival and quality of life after hypofractionated stereotactic radiotherapy for recurrent malignant glioma. J Neurooncol 81 : 287-294, 2007 https://doi.org/10.1007/s11060-006-9231-0
  7. Fogh S, Glass C, Andrews DW, Werner-Wasik M : Multiple courses of stereotactic re-irradiation in recurrent oligodendroglioma: a case report. J Med Case Rep 5 : 183, 2011 https://doi.org/10.1186/1752-1947-5-183
  8. Kano H, Niranjan A, Khan A, Flickinger JC, Kondziolka D, Lieberman F, et al. : Does radiosurgery have a role in the management of oligodendrogliomas? J Neurosurg 110 : 564-571, 2009 https://doi.org/10.3171/2008.5.17582
  9. Kim HR, Kim KH, Kong DS, Seol HJ, Nam DH, Lim DH, et al. : Outcome of salvage treatment for recurrent glioblastoma. J Clin Neurosci 22 : 468-473, 2015 https://doi.org/10.1016/j.jocn.2014.09.018
  10. Kong DS, Lee JI, Park K, Kim JH, Lim DH, Nam DH : Efficacy of stereotactic radiosurgery as a salvage treatment for recurrent malignant gliomas. Cancer 112 : 2046-2051, 2008 https://doi.org/10.1002/cncr.23402
  11. Larson DA, Prados M, Lamborn KR, Smith V, Sneed PK, Chang S, et al. : Phase II study of high central dose gamma knife radiosurgery and marimastat in patients with recurrent malignant glioma. Int J Radiat Oncol Biol Phys 54 : 1397-1404, 2002 https://doi.org/10.1016/S0360-3016(02)03743-4
  12. Minniti G, Armosini V, Salvati M, Lanzetta G, Caporello P, Mei M, et al. : Fractionated stereotactic reirradiation and concurrent temozolomide in patients with recurrent glioblastoma. J Neurooncol 103 : 683-691, 2011 https://doi.org/10.1007/s11060-010-0446-8
  13. Niyazi M, Siefert A, Schwarz SB, Ganswindt U, Kreth FW, Tonn JC, et al. : Therapeutic options for recurrent malignant glioma. Radiother Oncol 98 : 1-14, 2011 https://doi.org/10.1016/j.radonc.2010.11.006
  14. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. : Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5 : 649-655, 1982 https://doi.org/10.1097/00000421-198212000-00014
  15. Reifenberger GKJBP, Louis DN, Collins VP : Astrocytic and oligodendroglioma in Kleihues P in Cavenee WK (ed) : World health organization classification of tumours, Pathology and genetics of tumours of the nervous system. IARC Press : Lyon, 2000, pp56-67
  16. Sarkar A, Pollock BE, Brown PD, Gorman DA : Evaluation of gamma knife radiosurgery in the treatment of oligodendrogliomas and mixed oligoden- droastrocytomas. J Neurosurg 97(5 Suppl) : 653-656, 2002
  17. Sheehan JP, Lee CC : Stereotactic radiosurgery for recurrent high-grade gliomas. World Neurosurg 82 : e593-e595, 2014 https://doi.org/10.1016/j.wneu.2014.06.042
  18. Simonetti G, Gaviani P, Botturi A, Innocenti A, Lamperti E, Silvani A : Clinical management of grade III oligodendroglioma. Cancer Manag Res 7 : 213-223, 2015
  19. Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. : Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352 : 987-996, 2005 https://doi.org/10.1056/NEJMoa043330

피인용 문헌

  1. Sonodynamic Therapy for Gliomas. Perspectives and Prospects of Selective Sonosensitization of Glioma Cells vol.8, pp.11, 2019, https://doi.org/10.3390/cells8111428
  2. Gamma Knife Radiosurgery for High-Grade Gliomas: Single-Center Experience of Six Years in China vol.99, pp.3, 2018, https://doi.org/10.1159/000509782