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Case Reports in Medicine
Volume 2012, Article ID 545492, 6 pages
http://dx.doi.org/10.1155/2012/545492
Case Report

Long-Term Survival after Gamma Knife Radiosurgery in a Case of Recurrent Glioblastoma Multiforme: A Case Report and Review of the Literature

1Gamma Knife of Spokane, Deaconess Health and Education Building, 910 W 5th Avenue, Suite 102, Spokane, WA 99204, USA
2Cancer Care Northwest, 910 W 5th Avenue, Suite 102, Spokane, WA 99204, USA
3MacKay & Meyer MDs, 711 S Cowley Street, Suite 210, Spokane, WA 99202, USA
4Spokane Brain & Spine, 801 W 5th Avenue, Suite 210, Spokane, WA 99204, USA

Received 22 December 2011; Accepted 15 January 2012

Academic Editor: Edward V. Craig

Copyright © 2012 Sudheer R. Thumma 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

The management of recurrent glioblastoma is highly challenging, and treatment outcomes remain uniformly poor. Glioblastoma is a highly infiltrative tumor, and complete surgical resection of all microscopic extensions cannot be achieved at the time of initial diagnosis, and hence local recurrence is observed in most patients. Gamma Knife radiosurgery has been used to treat these tumor recurrences for select cases and has been successful in prolonging the median survival by 8–12 months on average for select cases. We present the unique case of a 63-year-old male with multiple sequential recurrences of glioblastoma after initial standard treatment with surgery followed by concomitant external beam radiation therapy and chemotherapy (temozolomide). The patient was followed clinically as well as with surveillance MRI scans at every 2-3-month intervals. The patient underwent Gamma Knife radiosurgery three times for 3 separate tumor recurrences, and the patient survived for seven years following the initial diagnosis with this aggressive treatment. The median survival in patients with recurrent glioblastoma is usually 8–12 months after recurrence, and this unique case illustrates that aggressive local therapy can lead to long-term survivors in select situations. We advocate that each patient treatment at the time of recurrence should be tailored to each clinical situation and desire for quality of life and improved longevity.