[Results of salvage stereotactic radiosurgery in 14 patients with grade III or IV gliomas].
OBJECTIVE
To determine local control and overall survival rates of 14 patients treated for a grade III or IV glioma relapsing in a previously irradiated area and re-irradiated by stereotactic radiosurgery.


METHODS
From January 1997 to October 2001, 14 patients (median age 52 Years, age range 49-58 Years, Karnofski performance score 80 to 100) received radiosurgery for a relapse of grade III (3 patients) and or grade IV (10 patients) malignant gliomas. Before relapse, all patients had undergone surgery and had been given with a classical radiation protocol. Median maximum diameter and Volume of the tumors were 38.5mm (24-86mm) and 7cm3 (2-35cm3), respectively.


RESULTS
Median maximal dose at the isocenter and median minimal dose at the periphery of the lesion were 21Gy (16-38Gy) and 13Gy (9-17Gy), respectively. Mean follow-up was 8.5 Months (1-29). Median overall survival was 11.6 Months; 6-Month, 1- and 2-Year overall survival rates were 85p.100, 36p.100 and 12p.100, respectively. At univariate analysis, only histological grade was a significant prognostic factor of overall survival (p=0.03). Median disease-free survival was 8.2 Months while 6-Month and 1-Year disease-free survival rates were 69p.100 and 14p.100, respectively. According to univariate analysis, histological grade (p=0.033) and minimal dose delivered at the margin of the target Volume (p=0.02) were prognostic factors for disease-free survival. Two patients developed a symptomatic radionecrosis.


CONCLUSIONS
Radiosurgery of relapsed primitive high-grade brain tumors is efficient and overall survival rates were encouraging.
Service de Cancérologie / Radiothérapie, Paris. noel@ipno.in2p3.fr
G
G
Noël
Chiraz N
CN
Ben Ammar
L
L
Feuvret
C-A
CA
Valery
P
P
Cornu
G
G
Boisserie
J-M
JM
Simon
D
D
Hasboun
B
B
Tep
J-Y
JY
Delattre
M
M
Sanson
F
F
Baillet
J-J
JJ
Mazeron
D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011829:Radiation Dosage; D016634:Radiosurgery / Q000009:adverse effects; D016879:Salvage Therapy; D016019:Survival Analysis