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  • Clinical Outcomes of Gamma Knife Radiosurgery in the Primary Treatment of Patients with High-grade Glioma

    Final Number:
    1562

    Authors:
    Jose E. Valerio MD; Andres M Alvarez-Pinzon MD, MSc, PhD(c); Sam Coy PhD; Marcos Sanchez Gonzalez MD, PhD; Aizik L. Wolf MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Gamma knife radio-surgery has become progressively utilized as a treatment modality for patients diagnosed with gliomas. The purpose of this study is to evaluate the survival advantage for patients diagnosed with grade IV glioma that are treated with stereotactic radiosurgery followed by temodar chemotherapy.

    Methods: This is a Prospective, single-center, study evaluating subjects undergoing primary CNS Lymphoma treatment with radiosurgery using gamma knife perfection and chemotherapy. The study was designed to evaluate of a minimum of 100 patients in terms of survival rate, quality of life and neurological disability. Preoperative analysis includes age, gender, body mass index (BMI), smoking history, number and size of the brain lesions, estimated total radiosurgery dosage, quemotheraphy received.

    Results: The median survival from time at diagnosis was 31.6 months (95%CI: 17.4-44.7) with progression-free survival 17.6 months, (95%CI: 12.5-28.3), and local tumor control 68%. A multivariate analysis adjusted for possible confounding factors (tumor volume, recursive partitioning analysis class, neurological deficits, time to recurrence, adjuvant therapy, and tumor location) showed considerably longer survival. Time to the 1st recurrence was (mo) 18.5 (median) (range, 4-43). Adjuvant chemotherapy was 82% Temo, 18% PCV.

    Conclusions: Gamma knife radiosurgery is a secure alternative for selected cases diagnosed with high-grade glioma. Although treatment outcomes have improved in the past years, additional evidence in the clinical design of prospective, randomized, blinded clinical trials is needed to evaluate the strength of treating patients in detailed scientific situations.

    Patient Care: As a tool in a Minimal invasive procedure with tumor control and better quality of life

    Learning Objectives: Current minimally invasive treatments in High grade gliomas

    References:

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