Survival following stereotactic radiosurgery for newly diagnosed and recurrent glioblastoma multiforme: A multicenter experience

Alan T. Villavicencio, Sigita Burneikien, Pantaleo Romanelli, Lee McNeely, John D. Lipani, Laura Fariselli, Melinda McIntyre, Steven D. Chang, Ewell L. Nelson, Giovanni Broggi, John R. Adler, Jeffrey J. Thramann

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Background: Despite decades of clinical trials investigating new treatment modalities for glioblastoma multiforme (GBM), there have been no signifi cant treatment advances since the 1980s. Reported median survival times for patients with GBM treated with current modalities generally range from 9 to 19 months. The purpose of the current study is to retrospectively review the ability of CyberKnife® (Accuray Inc., Sunnyvale, Calif., USA) radiosurgery to provide local tumor control of newly diagnosed or recurrent GBM. Methods: 46 patients were treated at multiple institutions between August 2002 and September 2005. 20 patients (43.5%) underwent CyberKnife® treatment at the time of the initial diagnosis and/or during the first 3 months of their initial clinical management. 26 patients (56.5%) were treated at the time of tumor recurrence or progression. CyberKnife® was performed in addition to the traditional therapy. Results: Median survival (Kaplan Meier analysis) for the patients treated with radiosurgery as an initial clinical therapy was 9.5 months from SRS compared to 7 months for the patients treated at the time of tumor recurrence or progression (p = 0.8). Survival time from diagnosis was significantly (p = 0.0004) longer for patients treated upon recurrence, 21 vs. 11.5 months. Cox proportional hazards survival regression analysis demonstrated that survival time did not correlate significantly with treatment parameters (Dmax, Dmin, number of fractions) or target volume. Survival time and recursive partitioning analysis class were not correlated (p = 0.07). Patients with more extensive surgical interventions survived longer (p = 0.008), especially those who underwent total tumor resection vs. biopsy (p = 0.004). Conclusion: There is no apparent survival advantage in using CyberKnife® in initial management of glioblastoma patients and it should be reserved for patients whose tumors recur or progress after conventional therapy.

Original languageEnglish
Title of host publicationRadiosurgery
Pages288-299
Number of pages12
Volume7
DOIs
Publication statusPublished - 2010

Publication series

NameRadiosurgery
Volume7
ISSN (Print)10242651
ISSN (Electronic)16623940

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Surgery
  • Medicine(all)

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