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BioMed Research International
Volume 2014 (2014), Article ID 657953, 10 pages
http://dx.doi.org/10.1155/2014/657953
Clinical Study

Salvage Radiosurgery for Selected Patients with Recurrent Malignant Gliomas

1Radiation Oncology Department, Virgen de las Nieves University Hospital, 18014 Granada, Spain
2Neurosurgery Department, Virgen de las Nieves University Hospital, 18014 Granada, Spain
3Medical Physics Department, Virgen de las Nieves University Hospital, 18014 Granada, Spain

Received 13 February 2014; Revised 13 April 2014; Accepted 16 April 2014; Published 7 May 2014

Academic Editor: Giuseppe Lombardi

Copyright © 2014 Miguel Martínez-Carrillo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To analyse the survival after salvage radiosurgery and to identify prognostic factors. Methods. We retrospectively reviewed 87 consecutive patients, with recurrent high-grade glioma, that underwent stereotactic radiosurgery between 1997 and 2010. We evaluated the survival after initial diagnosis and after reirradiation. The prognostic factors were analysed by bivariate and multivariate Cox regression model. Results. The median age was 48 years old. The primary histology included anaplastic astrocytoma (47%) and glioblastoma (53%). A margin dose of 18 Gy was administered in the majority of cases (74%). The median survival after initial diagnosis was 21 months (39 months for anaplastic astrocytoma and 18.5 months for glioblastoma) and after reirradiation it was 10 months (17 months for anaplastic astrocytoma and 7.5 months for glioblastoma). In the bivariate analyses, the prognostic factors significantly associated with survival after reirradiation were age, tumour and treatment volume at recurrence, recursive partitioning analyses classification, Karnofsky performance score, histology, and margin to the planning target volume. Only the last four showed significant association in the multivariate analyses. Conclusion. stereotactic radiosurgery is a safe and may be an effective treatment option for selected patients diagnosed with recurrent high-grade glioma. The identified prognostic factors could help individualise the treatment.