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Stereotactic radiosurgery for patients with newly diagnosed glioblastoma multiforme (GBM): comparison with intra-operative radiotherapy and evaluation of prognostic factors

Published online by Cambridge University Press:  01 September 2007

Masayuki Matsuo ,
Jun Shinoda ,
Kazuhiro Miwa ,
Hirohito Yano ,
Toru Iwama ,
Shinya Hayashi ,
Sunaho Okada ,
Osamu Tanaka  and
Hiroaki Hoshi
Masayuki Matsuo*
Affiliation:
Department of Radiation Oncology Gifu, Japan
Jun Shinoda
Affiliation:
Chubu Medical Centre for Prolonged Traumatic Brain Dysfunction, Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Japan Gifu, Japan
Kazuhiro Miwa
Affiliation:
Chubu Medical Centre for Prolonged Traumatic Brain Dysfunction, Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Japan Gifu, Japan
Hirohito Yano
Affiliation:
Department of Neurosurgery, Gifu, Japan
Toru Iwama
Affiliation:
Department of Neurosurgery, Gifu, Japan
Shinya Hayashi
Affiliation:
Department of Radiology, Gifu University School of Medicine, Gifu, Japan
Sunaho Okada
Affiliation:
Department of Radiology, Gifu University School of Medicine, Gifu, Japan
Osamu Tanaka
Affiliation:
Department of Radiology, Gifu University School of Medicine, Gifu, Japan
Hiroaki Hoshi
Affiliation:
Department of Radiology, Gifu University School of Medicine, Gifu, Japan
*
Correspondence to: Masayuki Matsuo, Department of Radiation Oncology, Kizawa Memorial Hospital, 590 Shimokobi, Minokamo 505-8503, Japan. E-mail: [email protected]
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Abstract

The goals of this study were (1) to compare, in a single institute, the clinical results of patients with newly diagnosed glioblastoma multiforme (GBM) treated with stereotactic radiosurgery (SRS), which has been incorporated into the initial management approach, with those in-patients treated with intra-operative radiotherapy (IORT) and (2) to assess whether these local irradiation boost therapies are prognostic factors on survival analysis. One hundred and twenty adult patients with supratentorial GBM had undergone tumour resection or biopsy and had received external beam radiotherapy (EBRT). Of them, 31 underwent IORT, 29 underwent SRS, and the remaining 60 had no local high-dose irradiation boost. The local irradiation boost led to clearly better results on survival of GBM patients. Furthermore, SRS is less invasive and allows for meticulous target planning of the irradiation boost, and was superior to IORT in terms of survival prolongation as well as suppression of local tumour recurrence/progression at the primary site in this series. In addition, SRS was a significant, positive prognostic factor for survival as well as gross-total resection of the tumour, and could be an alternative therapeutic modality to IORT for GBM.

Keywords

Glioblastoma multiformeintra-operative radiotherapylocal recurrenceprognostic factorstereotactic radiosurgery
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 6 , Issue 3 , September 2007 , pp. 143 - 152
Copyright
Copyright © Cambridge University Press 2007

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References

Ramsey, RG, Brand, WN. Radiotherapy of glioblastoma multiforme. J Neurosurg 1973; 39:197–202.CrossRefGoogle ScholarPubMed
Walker, MD, Alexander, E Jr, Hunt, WE, et al. . Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 1978; 49:333–343.CrossRefGoogle ScholarPubMed
Walker, MD, Strike, TA, Sheline, GE. An analysis of dose-effect relationship in the radiotherapy of malignant gliomas. Int J Radiat Oncol Biol Phys 1979; 5:1725–1731.CrossRefGoogle ScholarPubMed
Walker, MD, Green, SB, Byar, DP, et al. . Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 1980; 303:1323–1329.CrossRefGoogle ScholarPubMed
Kristiansen, K, Hagen, S, Kollevold, T, et al. . Combined modality therapy of operated astrocytomas grade III and IV. Confirmation of the value of postoperative irradiation and lack of potentiation of bleomycin on survival time: a prospective multicenter trial of the Scandinavian Glioblastoma Study Group. Cancer 1981; 47:649–652.3.0.CO;2-W>CrossRefGoogle Scholar
Bleehen, NM, Stenning, SP. A Medical Research Council trial of two radiotherapy doses in the treatment of grades 3 and 4 astrocytoma. The Medical Research Council Brain Tumour Working Party. Br J Cancer 1991; 64:769–774.CrossRefGoogle ScholarPubMed
Hess, CF, Schaaf, JC, Kortmann, RD, Schabet, M, Bamberg, M. Malignant glioma: patterns of failure following individually tailored limited volume irradiation. Radiother Oncol 1994; 30:146–149.CrossRefGoogle ScholarPubMed
Werner-Wasik, M, Scott, CB, Nelson, DF, Gaspar, LE, Murray, KJ, Fischbach, JA, Nelson, JS, Weinstein, AS, Curran, WJ. Final report of a phase I/II trial of hyperfractionated and accelerated hyperfractionated radiation therapy with carmustine for adults with supratentorial malignant gliomas. Radiation Therapy Oncology Group Study 83-02. Cancer 1996; 77:1535–1543.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Coughlin, C, Scott, C, Langer, C, Coia, L, Curran, W, Rubin, P. Phase II, two-arm RTOG trial (94-11) of bischloroethyl-nitrosourea plus accelerated hyperfractionated radiotherapy (64.0 or 70.4 Gy) based on tumor volume (>20 or ≤20 cm2, respectively) in the treatment of newly-diagnosed radiosurgery-ineligible glioblastoma multiforme patients. Int J Radiat Oncol Biol Phys 2000; 48:1351–1358.CrossRefGoogle ScholarPubMed
Prados, MD, Wara, WM, Sneed, PK, et al. . Phase II trial of accelerated hyperfractionation with or without difluromethylornithine (DFMO) versus standard fractionated radiotherapy with or without DFMO for newly diagnosed patients with glioblastoma multiforme. Int J Radiat Oncol Biol Phys 2001; 49:71–77.CrossRefGoogle ScholarPubMed
Sakai, N, Yamada, H, Andoh, T, Hirata, T, Nishimura, Y, Miwa, Y, Shimizu, K, Yanagawa, S. Intraoperative radiation therapy for malignant glioma. Neurol Med Chir (Tokyo) 1991; 31:702–707.CrossRefGoogle ScholarPubMed
Matsutani, M, Nakamura, O, Nagashima, T, Asai, A, Fujimaki, T, Tanaka, H, Nakamura, M, Ueki, K, Tanaka, Y, Matsuda, T. Intra-operative radiation therapy for malignant brain tumours: rationale, method, and treatment results of cerebral glioblastomas. Acta Neurochir (Wien) 1994; 131:80–90.CrossRefGoogle ScholarPubMed
Fernandez, PM, Zamorano, L, Yakar, D, Gaspar, L, Warmelink, C. Permanent iodine-125 implants in the up-front treatment of malignant gliomas. Neurosurgery 1995; 36:467–473.Google ScholarPubMed
Fujiwara, T, Honma, Y, Ogawa, T, Irie, K, Kuyama, H, Nagao, S, Takashima, H, Hosokawa, A, Ohkawa, M, Tanabe, M. Intraoperative radiotherapy for gliomas. J Neurooncol 1995; 23:81–86.CrossRefGoogle ScholarPubMed
Sneed, PK, Prados, MD, McDermott, MW, et al. . Large effect of age on the survival of patients with glioblastoma treated with radiotherapy and brachytherapy boost. Neurosurgery 1995; 36:898–904.CrossRefGoogle ScholarPubMed
Laperriere, NJ, Leung, PMK, McKenzie, S, Milosevic, M, Wong, S, Glen, J, Pintilie, M, Bernstein, M. Randomized study of brachytherapy in the initial management of patients with malignant astrocytoma. Int J Radiat Oncol Biol Phys 1998; 41:1005–1011.CrossRefGoogle ScholarPubMed
Videtic, GM, Gaspar, LE, Zamorano, L, Fontanesi, J, Levin, KJ, Kupsky, WJ, Tekyi-Mensah, S. Use of the RTOG recursive partitioning analysis to validate the benefit of iodine-125 implants in the primary treatment of malignant gliomas. Int J Radiat Oncol Biol Phys 1999; 45:687–692.CrossRefGoogle ScholarPubMed
Selker, RG, Shapiro, WR, Burger, P, et al. . The Brain Tumor Cooperative Group NIH Trial 87-01: a randomized comparison of surgery, external radiotherapy, and carnustine versus surgery, interstitial radiotherapy boost, external radiation therapy, and carmustine. Neurosurgery 2002; 51:343–355 discussion 355–357.CrossRefGoogle ScholarPubMed
Loeffler, JS, Alexander, E III, Shea, WM, Wen, PY, Fine, HA, Kooy, HM, Black, PM. Radiosurgery as part of the initial management of patients with malignant gliomas. J Clin Oncol 1992; 10:1379–1385.CrossRefGoogle ScholarPubMed
Karnofsky, DA, Burchenal, JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod, CM (ed). Evaluation of Chemotherapeutic Agents. New York: Colombia University Press, 1945, pp. 191–205.Google Scholar
Shinoda, J, Sakai, N, Hara, A, Ueda, T, Sakai, H, Nakatani, K. Clinical trial of external beam-radiotherapy combined with daily administration of low-dose cisplatin for supratentorial glioblastoma multiforme—A pilot study. J Neurooncol 1997; 35:73–80.CrossRefGoogle ScholarPubMed
Kaplan, EC, Meier, P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53:447–454.CrossRefGoogle Scholar
Cox, DR. Regression models and life tables (with discussion). J R Stat Soc (B) 1972; 32:187–220.Google Scholar
Buatti, JM, Friedman, WA, Bova, FJ, Mendenhall, WM. Linac radiosurgery for high-grade gliomas: the University of Florida experience. Int J Radiat Oncol Biol Phys 1995; 32:205–210.CrossRefGoogle ScholarPubMed
Gannett, D, Stea, B, Lulu, B, Adair, T, Verdi, C, Hamilton, A. Stereotactic radiosurgery as an adjunct to surgery and external beam radiotherapy in the treatment of patients with malignant gliomas. Int J Radiat Oncol Biol Phys 1995; 33:461–468.CrossRefGoogle ScholarPubMed
Masciopinto, JE, Levin, AB, Mehta, MP, Rhode, BS. Stereotactic radiosurgery for glioblastoma: a final report of 31 patients. J Neurosurg 1995; 82:530–535.CrossRefGoogle ScholarPubMed
Larson, DA, Gutin, PH, McDermott, M, et al. . Gamma knife for glioma: selection factors and survival. Int J Radiat Oncol Biol Phys 1996; 36:1045–1053.CrossRefGoogle ScholarPubMed
Kondziolka, D, Flickinger, JC, Bissonette, DJ, Bozik, M, Lunsford, LD. Survival benefit of stereotactic radiosurgery for patients with malignant glial neoplasms. Neurosurgery 1997; 41:776–783, discussion 783–785.CrossRefGoogle ScholarPubMed
Shenouda, G, Souhami, L, Podgorsak, EB, Bahary, JP, Villemure, JG, Caron, JL, Mohr, G. Radiosurgery and accelerated radiotherapy for patients with glioblastoma. Can J Neurol Sci 1997; 24:110–115.CrossRefGoogle ScholarPubMed
Cardinale, RM, Schmidt-Ullrich, RK, Benedict, SH, Zwicker, RD, Han, DC, Broaddus, WC. Accelerated radiotherapy regimen for malignant gliomas using stereotactic concomitant boosts for dose escalation. Radiat Oncol Investig 1998; 6:175–181.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
van Kampen, M, Engenhart-Cabillic, R, Debus, J, Fuss, M, Rhein, B, Wannenmacher, M. Stellenwert der Radiochirurgie in der Primärtherapie des Glioblastoma multiforme. Strahlenther Onklol 1998; 174:187–192.CrossRefGoogle ScholarPubMed
Shrieve, DC, Alexander, E III, Black, PM, Wen, PY, Fine, HA, Kooy, HM, Loeffler, JS. Treatment of patients with primary glioblastoma multiforme with standard postoperative radiotherapy and radiosurgical boost: prognostic factors and long-term outcome. J Neurosurg 1999; 90:72–77.CrossRefGoogle ScholarPubMed
Nwokedi, EC, DiBiase, SJ, Jabbour, S, Herman, J, Amin, P, Chin, LS. Gamma knife stereotactic radiosurgery for patients with glioblastoma multiforme. Neurosurgery 2002; 50:41–46, discussion 46–47.Google ScholarPubMed
Prisco, FE, Weltman, E, de Hanriot, RM, Brandt, RA. Radiosurgical boost for primary high-grade gliomas. J Neurooncol 2002; 57:151–160.CrossRefGoogle ScholarPubMed
Shinoda, J, Yano, H, Ando, H, Ohe, N, Sakai, N, Saio, M, Shimokawa, K. Radiological response and histological changes in malignant astrocytic tumors after stereotactic radiosurgery. Brain Tumor Pathol 2002; 19:83–92.CrossRefGoogle ScholarPubMed
Miwa, K, Shinoda, J, Yano, H, Okumura, A, Iwama, T, Nakashima, T, Sakai, N. Discrepancy between lesion distributions on methionine PET and MR images in patients with glioblastoma multiforme: insight from a PET and MR fusion image study. J Neurol Neurosurg Psychiatry 2004; 75:1457–1462.CrossRefGoogle Scholar