Gamma Knife Stereotactic Radiosurgery in Combination with Bevacizumab for Recurrent Glioblastoma.

摘要: Background Prior retrospective and prospective studies suggest improved survival with the use of stereotactic radiosurgery (SRS) bevacizumab in treatment limited-volume glioblastoma (GBM) recurrences. Methods We retrospectively reviewed our experience gamma knife SRS combination for focal GBM recurrence during 2009–2015. Outcomes include overall survival, progression free (PFS), radiation-related adverse events. Kaplan–Meier methods multivariable Cox proportional hazards models were performed analysis. Results Within a median 13.7 months after diagnosis, total 45 patients underwent treatment. Median age was 57 years (range: 20–78 years) 63.3% women. The Karnofsky Performance Score (KPS) at 80 40–100). Sixty-four percent had single target 1–4) volume margin dose 2.2 cm3 0.1–25.2 cm3) 17.0 gray (Gy) 13–24 Gy), respectively. PFS 9.3, 31.0 following 5.2, 13.3 SRS, Factors associated poor outcomes KPS ≤70, Conclusions can be safely used to treat recurrence. KPS, radiation dose, multi-agent chemotherapy usage prior demonstrated significant impact on PFS. Bevacizumab may provide clinically relevant radioprotection.