Cyberknife re-irradiation for recurrent glioblastoma multiforme

Abstract

Objective: Treatment of patients with recurrent glioblastoma multiforme (GBM) is challenging. Treatment alternatives include re-operation, chemotherapy and re-irridation. Stereotactic radiosurgery with cyberknife is a good therapeutic approach to deliver high-dose radiation to a definite target volume with minimizing re-irradiation to nearby healthy tissues. This study, evaluated the efficacy of cyberknife treatment in 24 patients with recurrent GBM. Methods: Total 24 patients with recurrent GBM who received cyberknife treatment in any line of recurrence between the 2011, 2015 were included in this study. A median dose of 30 Gy was applied to each patient. Results: Median survival was 10.3 months after cyberknife treatment and 23 months after diagnosis. Patients younger than 60 years (4.8 vs 14.2 month; p:0.05) and patients with primary total tumor excision (9.3 vs 4.9 month; p:0.05) had longer overall survival than other patients in univariate analysis but not in multivariate analysis. In this patient population, any other variables predicting longer overall survival could not be found. Treatment was well-tolerated and no severe toxicities observed. Conclusion: Although limitations exist, our study demonstrates that SRS in terms of cyberknife for recurrent GBM is feasible and well tolerated by patients with low toxicity.