doiSerbia

Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: A single center experience

Sirin Sait (Gulhane Military Medical Academy, Department of Neurosurgery, Ankara, Turkey)
Oysul Kaan (Gulhane Military Medical Academy, Department of Radiation Oncology, Ankara, Turkey)
Surenkok Serdar (Gulhane Military Medical Academy, Department of Radiation Oncology, Ankara, Turkey)
Sager Omer (Gulhane Military Medical Academy, Department of Radiation Oncology, Ankara, Turkey)
Dincoglan Ferrat (Gulhane Military Medical Academy, Department of Radiation Oncology, Ankara, Turkey)
Dirican Bahar (Gulhane Military Medical Academy, Department of Radiation Oncology, Ankara, Turkey)
Beyzadeoglu Murat (Gulhane Military Medical Academy, Department of Radiation Oncology, Ankara, Turkey)

Background/Aim. Management of patients with recurrent glioblastoma (GB) comprises a therapeutic challenge in neurooncology owing to the aggressive nature of the disease with poor local control despite a combined modality treatment. The majority of cases recur within the highdose radiotherapy field limiting the use of conventional techniques for re-irradiation due to potential toxicity. Stereotactic radiosurgery (SRS) offers a viable noninvasive therapeutic option in palliative treatment of recurrent GB as a sophisticated modality with improved setup accuracy allowing the administration of high-dose, precise radiotherapy. The aim of the study was to, we report our experience with single-dose linear accelerator (LINAC) based SRS in the management of patients with recurrent GB. Methods. Between 1998 and 2010 a total of 19 patients with recurrent GB were treated using single-dose LINAC-based SRS. The median age was 47 (23-65) years at primary diagnosis. Karnofsky Performance Score was ≥ 70 for all the patients. The median planning target volume (PTV) was 13 (7-19) cc. The median marginal dose was 16 (10-19) Gy prescribed to the 80%-95% isodose line encompassing the planning target volume. The median follow-up time was 13 (2-59) months. Results. The median survival was 21 months and 9.3 months from the initial GB diagnosis and from SRS, respectively. The median progression-free survival from SRS was 5.7 months. All the patients tolerated radiosurgical treatment well without any Common Toxicity Criteria (CTC) grade > 2 acute side effects. Conclusion. Single-dose LINAC-based SRS is a safe and well- tolerated palliative therapeutic option in the management of patients with recurrent GB.

Keywords: glioblastoma, recurrence, palliative care, radiosurgery, particle accelerators