title: The possible role of linac-based stereotactic radiotherapy in the treatment of multifocally and heterochronously recurrent malignant astrocytomas. A case report.
abstract: We present a 24-year-old woman with multifocal and heterochronous recurrence of malignant astrocytomas that were consecutively treated by linac-based sterotactic radiotherapy. The patient had previously received multimodalities of treatment for malignant astrocytomas in the right occipital lobe consisting of surgical resection on four occasions, conventional external-beam irradiation, immunological therapy, and systemic chemotherapy. Thereafter she developed relatively small and well-demarcated recurrent lesions in eight different sites, most of which were located in eloquent and deep-seated regions. She underwent ten fractionated linac-based stereotactic radiotherapy courses with a median total dose of 42 Gy, seven fractions of 6 Gy each in 15 days, experiencing neither any adverse effects nor neurologic deterioration. Three out of 10 treated lesions responded well with subsequent reduction in size, and 80% of them did not increase at least for 6 months, although 66.7% of the lesions eventually exhibited enlargement of the enhanced areas, some of which were presumed as radiation necrosis. These clinical results suggest that the fractionated linac-based stereotactic radiotherapy had significant effects on tumor growth inhibition and attainment of acceptable patient performance status.
authors.affiliation: Department of Neurosurgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nagane
authors.forename: S
authors.initials: S
authors.lastname: Shibui
authors.forename: H
authors.initials: H
authors.lastname: Oyama
authors.forename: K
authors.initials: K
authors.lastname: Nomura
authors.forename: M
authors.initials: M
authors.lastname: Sumi
authors.forename: K
authors.initials: K
authors.lastname: Tokuuye
authors.forename: Y
authors.initials: Y
authors.lastname: Akine
mesh_terms: D000328:Adult; D001254:Astrocytoma / Q000473:pathology / Q000601:surgery*; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D016634:Radiosurgery