Stereotactic radiosurgery for recurrent gliomas.
BACKGROUND
The treatment of recurrent gliomas is palliative; however, the local pattern of tumor recurrence permits retreatment with single fraction, high dose stereotactic radiotherapy or radiosurgery (RS).


METHODS
Twenty patients (median Karnofsky performance status, 80), aged 8-62 years with recurrent gliomas, were treated with RS after failing adjuvant therapy. Tumor histologies included glioblastoma multiforme (5), anaplastic astrocytoma (10), fibrillary astrocytoma (4), and primitive neuroectodermal tumor (1). Tumor volumes ranged from 3-53.5 cc, with a median of 17 cc.


RESULTS
Seven early and one late radiation complication were seen. All seven early radiation complications were due to raised intracranial pressure and resolved in all but one patient who died. Median follow-up in 19 evaluable patients was 8 months (range, 2-29 months). Fourteen patients died from progressive tumor (median survival, 7 months). Five patients, four with recurrent tumor, were alive (median follow-up, 19 months) with a median time-to-tumor progression of 9 months.


CONCLUSIONS
Radiosurgery demonstrates modest efficacy with acceptable toxicity in selected patients with recurrent gliomas and warrants further investigation.
Chamberlain
M C
MC
Department of Neurosciences, University of California, San Diego 92093-0812.
Barba
D
D
Kormanik
P
P
Shea
W M
WM
D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000601:surgery; D005910:Glioma / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011446:Prospective Studies; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D012074:Remission Induction; D013238:Stereotaxic Techniques; D015996:Survival Rate; D013997:Time Factors; D017211:Treatment Failure