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Radiosurgery reirradiation for high-grade glioma recurrence: a retrospective analysis

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An Erratum to this article was published on 12 April 2015

Abstract

Despite various treatment strategies being available, recurrent high-grade gliomas (r-HGG) are difficult to manage. To obtain local control, radiosurgery (SRS) reirradiation has been considered as potential treatment. In the present study, a retrospective analysis was performed on r-HGG patients treated with salvage single- (s-SRS) or multi-fraction SRS (m-SRS). The aim of this study was to evaluate the effectiveness of salvage SRS in terms of overall survival (OS); toxicity was analyzed as well. Between 2004 May and 2011 December, 128 r-HGG patients (161 lesions) treated with CyberKnife® SRS reirradiation were retrospectively analyzed. Toxicity was graded according to Radiation Therapy Oncology Group and by Common Terminology Criteria for Adverse Events v.3 criteria. OS from the diagnosis date and OS from reirradiation were estimated using the Kaplan–Meier method. Median follow-up was 9 months (range 15 days–82 months). All patients completed SRS without high-grade toxicity. Radiation necrosis was observed in seven patients (6 %) with large volume lesions. The median survival from initial diagnosis was 32 months. The 1-, 2-, and 3-years survival rates from diagnosis were 95, 62, and 45 % respectively. Median survival following SRS was 11.5 months. The 1-, 2-, and 3-years survival rate following SRS was 48, 20, and 17 % respectively. On multivariate analysis, age <40 years, salvage surgery before SRS, and other post-SRS therapies (second-line chemotherapy and/or surgery) were found to significantly improve survival (p = 0.03). SRS represents a safe and feasible option to treat r-HGG patients with low complication rates and potential survival benefit.

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Acknowledgments

The authors thank Dr. A. Harrington for reviewing the English of the manuscript and Milda Cerniauskaite for her collaboration.

Conflict of interest

The authors state that there are no conflicts of interest.

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Authors and Affiliations

  1. Radiotherapy Unit, Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, MI, Italy

    Valentina Pinzi, Marcello Marchetti, Ida Maddalena Milanesi & Laura Fariselli

  2. Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Severino Boezio 24, 27100, Pavia, Italy

    Chiara Orsi

  3. CyberKnife Center, CDI (Centro Diagnostico Italiano), Via Saint Bon 20, 20147, Milan, Italy

    Livia Corinna Bianchi

  4. Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy

    Francesco DiMeco, Paolo Ferroli & Angelo Franzini

  5. Neuroradiology Unit, Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy

    Valeria Cuccarini

  6. Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy

    Mariangela Farinotti

  7. Unit of Neuro-oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy

    Gaetano Finocchiaro & Antonio Silvani

  8. Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy

    MariaLuisa Fumagalli

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  1. Valentina Pinzi
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Correspondence to Valentina Pinzi.

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Pinzi, V., Orsi, C., Marchetti, M. et al. Radiosurgery reirradiation for high-grade glioma recurrence: a retrospective analysis. Neurol Sci 36, 1431–1440 (2015). https://doi.org/10.1007/s10072-015-2172-7

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