title: Long-term survival after gamma knife radiosurgery in a case of recurrent glioblastoma multiforme: a case report and review of the literature.
abstract: The management of recurrent glioblastoma is highly challenging, and treatment outcomes remain uniformly poor. Glioblastoma is a highly infiltrative tumor, and complete surgical resection of all microscopic extensions cannot be achieved at the time of initial diagnosis, and hence local recurrence is observed in most patients. Gamma Knife radiosurgery has been used to treat these tumor recurrences for select cases and has been successful in prolonging the median survival by 8-12 months on average for select cases. We present the unique case of a 63-year-old male with multiple sequential recurrences of glioblastoma after initial standard treatment with surgery followed by concomitant external beam radiation therapy and chemotherapy (temozolomide). The patient was followed clinically as well as with surveillance MRI scans at every 2-3-month intervals. The patient underwent Gamma Knife radiosurgery three times for 3 separate tumor recurrences, and the patient survived for seven years following the initial diagnosis with this aggressive treatment. The median survival in patients with recurrent glioblastoma is usually 8-12 months after recurrence, and this unique case illustrates that aggressive local therapy can lead to long-term survivors in select situations. We advocate that each patient treatment at the time of recurrence should be tailored to each clinical situation and desire for quality of life and improved longevity.
authors.affiliation: Gamma Knife of Spokane, Deaconess Health and Education Building, 910 W 5th Avenue, Suite 102, Spokane, WA 99204, USA.
authors.forename: Sudheer R
authors.initials: SR
authors.lastname: Thumma
authors.forename: Ameer L
authors.initials: AL
authors.lastname: Elaimy
authors.forename: Nathan
authors.initials: N
authors.lastname: Daines
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Mackay
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Lamoreaux
authors.forename: Robert K
authors.initials: RK
authors.lastname: Fairbanks
authors.forename: John J
authors.initials: JJ
authors.lastname: Demakas
authors.forename: Barton S
authors.initials: BS
authors.lastname: Cooke
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Lee