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Journal of Neuro-Oncology

Erschienen in:

01.02.2007 | Clinical-Patient Studies

Survival and quality of life after hypofractionated stereotactic radiotherapy for recurrent malignant glioma

verfasst von: Antje Ernst-Stecken, Oliver Ganslandt, Ulrike Lambrecht, Rolf Sauer, Gerhard Grabenbauer

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2007

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Abstract

Purpose

To prospectively evaluate efficacy, side effects and quality of life in patients with recurrent malignant glioma after hypofractionated stereotactic radiotherapy.

Methods and materials

From 1/2003 to 8/2005, 15 patients with recurrent malignant glioma were prospectively scheduled for hfSRT with 5 × 7 Gy (90%-isodose). Median gross tumor volume and planning target volume were 5.75 (range, 0.77–21.94) and 22.4 (range, 4.22–86.79) cc, respectively. Irradiation was performed with the dedicated stereotactic radiosurgery system Novalis™ (BrainLAB, Heimstetten, Germany).

Results

Rates of remission, no change and progressive disease were 27%, 33%, and 40%, respectively, after a median follow-up of 9 months. Progression-free survival rates at 6 and 12 months were 75% and 53% respectively. Quality of life, measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire scores could be kept stable in two thirds of the patients for a median time of 9 months, respectively. Conclusion: Hypofractionated stereotactic radiotherapy with 5 × 7 Gy of recurrent high grade glioma is an effective treatment that helps to maintain quality of life for an acceptable period, comparable to the results obtained with current chemotherapy schedules. Combined approaches of radiotherapy, chemotherapy and other targeted therapies deserve further inverstigation.

Nabors LB, Fiveash J (2005) Treatment of adults with recurrent malignant glioma. Expert Rev Neurother 5:509–514PubMedCrossRef

Tsao MN, Mehta MP, Whelan TJ, Morris DE, Hayman JA, Flickinger JC, Mills M, Rogers CL, Souhami L (2005) The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for malignant glioma. Int J Radiat Oncol Biol Phys 63:47–55PubMedCrossRef

Combs SE, Widmer V, Thilmann C, Hof H, Debus J, Schulz-Ertner D (2005) Stereotactic radiosurgery (SRS): treatment option for recurrent glioblastoma multiforme (GBM). Cancer 104:2168–2173PubMedCrossRef

Chamberlain MC, Barba D, Kormanik P, Shea WM (1994) Stereotactic radiosurgery for recurrent gliomas. Cancer 74:1342–1347PubMedCrossRef

Hall WA, Djalilian HR, Sperduto PW, Cho KH, Gerbi BJ, Gibbons JP, Rohr M, Clark HB (1995) Stereotactic radiosurgery for recurrent malignant gliomas. J Clin Oncol 13:1642–1648 PubMed

Brada M, Hoang-Xuan K, Rampling R, Dietrich PY, Dirix LY, Macdonald D, Heimans JJ, Zonnenberg BA, Bravo-Marques JM, Henriksson R, Stupp R, Yue N, Bruner J, Dugan M, Rao S, Zaknoen S (2001) Multicenter phase II trial of temozolomide in patients with glioblastoma multiforme at first relapse. Ann Oncol 12:259–266PubMedCrossRef

Franceschi E, Omuro AM, Lassman AB, Demopoulos A, Nolan C, Abrey LE (2005) Salvage temozolomide for prior temozolomide responders. Cancer [Epub ahead of print]

Prados MD Yung WK, Fine HA, Greenberg HS, Junck L, Chang SM, Nicholas MK, Robins HI, Mehta MP, Fink KL, Jaeckle KA, Kuhn J, Hess KR, Schold SC Jr (2004) Phase 2 study of BCNU and temozolomide for recurrent glioblastoma multiforme: North American Brain Tumor Consortium study. Neuro-oncol 6(1):33–37

Cho KH, Hall WA, Gerbi BJ, Higgins PD, McGuire WA, Clark HB (1999) Single dose versus fractionated stereotactic radiotherapy for recurrent high-grade gliomas. Int J Radiat Oncol Biol Phys 45:1133–1141PubMedCrossRef

10.

Ernst-Stecken A, Lambrecht U, Ganslandt O, Mueller R, Fahlbusch R, Sauer R, Grabenbauer G (2005) Radiosurgery of small skull-base lesions no advantage for intensity-modulated stereotactic radiosurgery versus conformal arc technique. Strahlenther Onkol 181:336–344PubMedCrossRef

11.

Shaw E, Kline R, Gillin M, Souhami L, Hirschfeld A, Dinapoli R, Martin L (1993) Radiation Therapy Oncology Group: radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys 27:1231–1239PubMed

12.

Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, et al. (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRef

13.

Fayers PM, Aaronson NK, Bjordal K, Groenvald M, Curran D, Bottomley A, on behalf of the EORTC Quality of Life Group (2001) The EORTC QLQ-C30 Scoring manual, 3rd edn. European Organisation for Research and Treatment of Cancer, Brussels

14.

Mahoney F, Barthel D (1965) Functional evaluation: the Barthel index. Md Med J 14:61–65

15.

MacDonald DR, Cascino TL, Schold SC Jr, Cairncross JG (1990) Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 8:1277–1280PubMed

16.

Kaplan EL, Meier P et al (1958) Nonparametric estimation from incomplete observation. J Am Stat Assn 53:457–481CrossRef

17.

Cox DR (1972) Regression models and life tables. J R Stat Soc B 34:187–220

18.

Wong ET, Hess KR, Gleason MJ, Jaeckle KA, Kyritsis AP, Prados MD, Levin VA, Yung WK (1999) Outcomes and prognostic factors in recurrent glioma patients enrolled onto phase II clinical trials. J Clin Oncol 17:2572–2578PubMed

19.

Bower M, Newlands ES, Bleehen NM, Brada M, Begent RJ, Calvert H, Colquhoun I, Lewis P, Brampton MH (1997) Multicentre CRC phase II trial of temozolomide in recurrent or progressive high-grade glioma. Cancer Chemother Pharmacol 40:484–488PubMedCrossRef

20.

Yung WK, Prados MD, Yaya-Tur R, Rosenfeld SS, Brada M, Friedman HS, Albright R, Olson J, Chang SM, O’Neill AM, Friedman AH, Bruner J, Yue N, Dugan M, Zaknoen S, Levin VA (1999) Multicenter phase II trial of temozolomide in patients with anaplastic astrocytoma or anaplastic oligoastrocytoma at first relapse. Temodal Brain Tumor Group. J Clin Oncol 17:2762–2771

21.

Larson DA, Prados M, Lamborn KR, Smith V, Sneed PK, Chang S, Nicholas KM, Wara WM, Devriendt D, Kunwar S, Berger M, McDermott MW (2002) Phase II study of high central dose Gamma Knife radiosurgery and marimastat in patients with recurrent malignant glioma. Int J Radiat Oncol Biol Phys 54:1397–1404PubMedCrossRef

22.

Combs SE, Gutwein S, Schulz-Ertner D, van Kampen M, Thilmann C, Edler L, Wannenmacher MM, Debus J (2005) Temozolomide combined with irradiation as postoperative treatment of primary glioblastoma multiforme phase I/II study. Strahlenther Onkol 181:372–377PubMedCrossRef

23.

Kocher M, Kunze S, Eich HT, Semrau R, Muller RP (2005) Efficacy and toxicity of postoperative temozolomide radiochemotherapy in malignant glioma. Strahlenther Onkol. 181:157–163PubMedCrossRef

24.

Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996PubMedCrossRef

25.

Quinn JA, Desjardins A, Weingart J, Brem H, Dolan ME, Delaney SM, Vredenburgh J, Rich J, Friedman AH, Reardon DA, Sampson JH, Pegg AE, Moschel RC, Birch R, McLendon RE, Provenzale JM, Gururangan S, Dancey JE, Maxwell J, Tourt-Uhlig S, Herndon JE 2nd, Bigner DD, Friedman HS (2005) Phase I trial of temozolomide plus O6-benzylguanine for patients with recurrent or progressive malignant glioma. J Clin Oncol 23:7178–7187PubMedCrossRef

26.

Wedge SR, Porteous JK, Glaser MG, Marcus K, Newlands ES (1997) In vitro evaluation of temozolomide combined with X-irradiation. Anticancer Drugs 8:92–97PubMedCrossRef

27.

Hochberg FH Pruitt A (1980) Assumptions in the radiotherapy of glioblastoma. Neurology 30:907–911

28.

Shepherd SF Laing RW, Cosgrove VP, Warrington AP, Hines F, Ashley SE, Brada M (1997) Hypofractionated stereotactic radiotherapy in the management of recurrent glioma. Int J Radiat Oncol Biol Phys 37:393–398CrossRef

29.

Hudes RS, Corn BW, Werner-Wasik M, Andrews D, Rosenstock J, Thoron L, Downes B, Curran WJ Jr (1999) A phase I dose escalation study of hypofractionated stereotactic radiotherapy as salvage therapy for persistent or recurrent malignant glioma. Int J Radiat Oncol Biol Phys 43:293–299PubMedCrossRef

30.

Vordermark D, Kolbl O, Ruprecht K, Vince GH, Bratengeier K, Flentje M (2005) Hypofractionated stereotactic re-irradiation: treatment option in recurrent malignant glioma. BMC Cancer 5:55PubMedCrossRef

31.

Voynov G, Kaufman S, Hong T, Pinkerton A, Simon R, Dowsett R (2002) Treatment of recurrent malignant gliomas with stereotactic intensity modulated radiation therapy. Am J Clin Oncol 25:606–611PubMedCrossRef

32.

Dhermain F, de Crevoisier R, Parker F, Cioloca C, Kaliski A, Beaudre A, Lefkopoulos D, Armand JP, Haie-Meder C (2004) Role of radiotherapy in recurrent gliomas. Bull Cancer 91:883–889PubMed

33.

Glass J, Silverman CL, Axelrod R, Corn BW, Andrews DW (1997) Fractionated stereotactic radiotherapy with cis-platinum radiosensitization in the treatment of recurrent, progressive, or persistent malignant astrocytoma. Am J Clin Oncol. 20:226–229PubMedCrossRef

34.

Lederman G, Arbit E, Odaimi M, Lombardi E, Wrzolek M, Wronski M (1998) Fractionated stereotactic radiosurgery and concurrent taxol in recurrent glioblastoma multiforme: a preliminary report. Int J Radiat Oncol Biol Phys 40:661–666PubMedCrossRef

35.

Laing RW, Warrington AP, Graham J, Britton J, Hines F, Brada M (1993) Efficacy and toxicity of fractionated stereotactic radiotherapy in the treatment of recurrent gliomas (phase I/II study). Radiother Oncol 27:22–29PubMedCrossRef

36.

Flickinger JC, Kondziolka D, Pollock BE, Maitz AH, Lunsford LD (1997) Complications from arteriovenous malformation radiosurgery: multivariate analysis and risk modeling. Int J Radiat Oncol Biol Phys 38:485–490PubMedCrossRef

37.

Weitzner MA, Meyers CA (1997) Cognitive functioning and quality of life in malignant glioma patients: a review of the literature. Psychooncology 6:169–177PubMedCrossRef

Titel: Survival and quality of life after hypofractionated stereotactic radiotherapy for recurrent malignant glioma
verfasst von: Antje Ernst-Stecken
Oliver Ganslandt
Ulrike Lambrecht
Rolf Sauer
Gerhard Grabenbauer
Publikationsdatum: 01.02.2007
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 3/2007
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-006-9231-0

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