Outcomes after stereotactic radiosurgery and various adjuvant treatments for recurrent glioblastoma multiforme: A current literature review and comparison of multiple factors that impact outcome

摘要

The current article, entitled "Gamma Knife Surgery versus Reoperation for Recurrent Glioblastoma Multi-forme," by Skeie et al., evaluated 77 patients with glioblastoma multiforme (GBM). All patients had undergone gross total resection (GTR) at the time of the initial treatment and then received 39 to 60 Gy of fractionated external-beam radiotherapy (FEBRT) within 8 weeks of the initial surgery. Thirty patients received FEBRT without, whereas 42 patients underwent FEBRT with chemotherapy (CTX). Of these 42 patients who received FEBRT with CTX, 13 (31%) who were treated from 1996 to 2004 received an FEBRT dose of 39-54 Gy and procarbazine, lomustine (CCNU), and vincristine (PCV) and 29 (69%) patients treated from 2005 onward received a higher FEBRT dose of 60 Gy and Temodar (TMZ). Five patients (6.5%) underwent FEBRT without radiation or CTX. The 77 patients who experienced tumor recurrence were treated as follows: 32 patients underwent gamma knife radiosurgery (GKR), 26 had reoperation, and 19 patients received both reoperation and GKS. The last category of 19 patients included patients with second recurrences, and 13 (68%) of these 19 underwent surgery for the first recurrence and radiosurgery for the second recurrence. The other 6 underwent both retreatments during the same hospitalization for residual tumor postresection.