Gamma Knife Radiosurgery for Low-Grade Gliomas: Clinical Results at Long-Term Follow-Up of Tumor Control and Patients' Quality of Life

被引:8
作者
Gagliardi, Filippo [1 ]
Bailo, Michele [1 ]
Spina, Alfio [1 ]
Donofrio, Carmine A. [1 ]
Boari, Nicola [1 ]
Franzin, Alberto [1 ]
Fava, Arianna [1 ]
del Vecchio, Antonella [2 ]
Bolognesi, Angelo [3 ]
Mortini, Pietro [1 ]
机构
[1] Univ Vita Salute San Raffaele, Dept Neurosurg & Gamma Knife Radiosurg, Milan, Italy
[2] Univ Vita Salute San Raffaele, Serv Med Phys, Milan, Italy
[3] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Serv Radiat Oncol, Milan, Italy
关键词
Brain tumor; Gamma Knife; Glioma; Low grade; Quality of life; Radiosurgery; STEREOTAXIC RADIOSURGERY; SURGERY; ASTROCYTOMAS; OLIGODENDROGLIOMA; RADIOTHERAPY; TRIAL;
D O I
10.1016/j.wneu.2017.02.041
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: First-line therapy for low-grade gliomas (LGGs) is surgery, in some cases followed by radiotherapy and chemotherapy. Gamma Knife radiosurgery (GKRS) has gained more relevance in the management of these tumors. The aim of this study was to assess efficacy and safety of GKRS for treatment of LGGs. METHODS: Between 2001 and 2014, 42 treatments were performed on 39 patients harboring LGGs; 48% of patients underwent previous surgery, and 20.5% underwent previous radiotherapy. Mean tumor volume was 2.7 cm(3), and median margin dose was 15 Gy. RESULTS: Mean follow-up was 60.5 months (range, 6-164 months). Actuarial progression-free survival was 74.9%, 52.8%, and 39.1% at 1 year, 5 years, and 10 years; actuarial overall survival was 97.4%, 94.6%, and 91.8% at 9 months, 1 year, and 5 years. Solid tumor control was achieved in 69.2% of patients, whereas cystic enlargement was recorded in 12.9% of cases. At last follow-up, volume reduction was recorded in 57.7% of cases, and median volume decreased by 33.3%. Clinical improvement was observed in 52.4% of patients. Karnofsky performance scale score was improved in 15 patients (45.5%), unchanged in 17 patients (51.5%), and worsened in 1 patient (3%). Mean posttreatment scores of 36-item short form health survey domains did not significantly differ from scores in a healthy Italian population. CONCLUSIONS: This study confirms safety and effectiveness of GKRS for LGGs in controlling tumor growth, relevantly improving patients' overall and progression-free survival. GKRS improved patients' functional performance and quality of life, optimizing social functioning and minimizing disease-related psychological impact.
引用
收藏
页码:540 / 553
页数:14
相关论文
共 50 条
[31]   Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas [J].
Ohgaki, H ;
Kleihues, P .
JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY, 2005, 64 (06) :479-489
[32]   TOXICITY AND RESPONSE CRITERIA OF THE EASTERN-COOPERATIVE-ONCOLOGY-GROUP [J].
OKEN, MM ;
CREECH, RH ;
TORMEY, DC ;
HORTON, J ;
DAVIS, TE ;
MCFADDEN, ET ;
CARBONE, PP .
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 1982, 5 (06) :649-655
[33]   Long-term outcome of low-grade oligodendroglioma and mixed glioma [J].
Olson, JD ;
Riedel, E ;
DeAngelis, LM .
NEUROLOGY, 2000, 54 (07) :1442-1448
[34]  
Ostrom QT, 2014, NEURO-ONCOLOGY, V16, P1, DOI [10.1093/neuonc/nov189, 10.1093/neuonc/nou223, 10.1093/neuonc/nou327, 10.1093/neuonc/nox158]
[35]   Early or delayed radiosurgery for WHO grade II astrocytomas [J].
Park, Kyung-Jae ;
Kano, Hideyuki ;
Kondziolka, Douglas ;
Niranjan, Ajay ;
Flickinger, John C. ;
Lunsford, L. Dade .
JOURNAL OF NEURO-ONCOLOGY, 2011, 103 (03) :523-532
[36]   A Comprehensive Review of MR Imaging Changes following Radiosurgery to 500 Brain Metastases [J].
Patel, T. R. ;
McHugh, B. J. ;
Bi, W. L. ;
Minja, F. J. ;
Knisely, J. P. S. ;
Chiang, V. L. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2011, 32 (10) :1885-1892
[37]   Fractionated stereotactic radiotherapy in low-grade astrocytomas: Long-term outcome and prognostic factors [J].
Plathow, C ;
Schulz-Ertner, D ;
Thilman, C ;
Zuna, I ;
Lichy, M ;
Weber, MA ;
Schlemmer, HP ;
Wannenmacher, M ;
Debus, J .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2003, 57 (04) :996-1003
[38]  
RANKIN J, 1957, Scott Med J, V2, P200
[39]   Feasibility and Efficacy of Repeated Chemotherapy for Progressive Pediatric Low-Grade Gliomas [J].
Scheinemann, Katrin ;
Bartels, Ute ;
Tsangaris, Elena ;
Hawkins, Cynthia ;
Huang, Annie ;
Dirks, Peter ;
Fried, Iris ;
Bouffet, Eric ;
Tabori, Uri .
PEDIATRIC BLOOD & CANCER, 2011, 57 (01) :84-88
[40]   RADIATION TOLERANCE LIMITS OF THE BRAINSTEM [J].
Sharma, Manish S. ;
Kondziolka, Douglas ;
Khan, Aftaab ;
Kano, Hideyuki ;
Niranjan, Ajay ;
Flickinger, John C. ;
Lunsford, L. Dade .
NEUROSURGERY, 2008, 63 (04) :728-732