Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: a single center experience

Vojnosanit Pregl. 2011 Nov;68(11):961-6. doi: 10.2298/vsp1111961s.


Background/aim: Management of patients with recurrent glioblastoma (GB) comprises a therapeutic challenge in neurooncology owing to the aggressive nature of the disease with poor local control despite a combined modality treatment. The majority of cases recur within the high-dose radiotherapy field limiting the use of conventional techniques for re-irradiation due to potential toxicity. Stereotactic radiosurgery (SRS) offers a viable noninvasive therapeutic option in palliative treatment of recurrent GB as a sophisticated modality with improved setup accuracy allowing the administration of high-dose, precise radiotherapy. The aim of the study was to, we report our experience with single-dose linear accelerator (LINAC) based SRS in the management of patients with recurrent GB.

Methods: Between 1998 and 2010 a total of 19 patients with recurrent GB were treated using single-dose LINAC-based SRS. The median age was 47 (23-65) years at primary diagnosis. Karnofsky Performance Score was > or = 70 for all the patients. The median planning target volume (PTV) was 13 (7-19) cc. The median marginal dose was 16 (10-19) Gy prescribed to the 80%-95% isodose line encompassing the planning target volume. The median follow-up time was 13 (2-59) months.

Results: The median survival was 21 months and 9.3 months from the initial GB diagnosis and from SRS, respectively. The median progression-free survival from SRS was 5.7 months. All the patients tolerated radiosurgical treatment well without any Common Toxicity Criteria (CTC) grade > 2 acute side effects.

Conclusion: Single-dose LINAC-based SRS is a safe and well- tolerated palliative therapeutic option in the management of patients with recurrent GB.

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms / surgery
  • Female
  • Glioblastoma / surgery
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery
  • Palliative Care
  • Radiosurgery / instrumentation
  • Radiosurgery / methods*
  • Young Adult