Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma
Abstract Background Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, with overall survival remaining poor despite ongoing efforts to explore new treatment paradigms. Given these outcomes, efforts have been made to shorten treatment time. Recent data report on the safety...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-022-10162-w |
| _version_ | 1811335375563522048 |
|---|---|
| author | Matthew Gallitto Michelle Savacool Albert Lee Tony J. C. Wang Michael B. Sisti |
| author_facet | Matthew Gallitto Michelle Savacool Albert Lee Tony J. C. Wang Michael B. Sisti |
| author_sort | Matthew Gallitto |
| collection | DOAJ |
| description | Abstract Background Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, with overall survival remaining poor despite ongoing efforts to explore new treatment paradigms. Given these outcomes, efforts have been made to shorten treatment time. Recent data report on the safety of CyberKnife (CK) fractionated stereotactic radiosurgery (SRS) in the management of GBM using a five-fraction regimen. The latest Gamma Knife (GK) model also supports frameless SRS, and outcomes using GK SRS in the management of primary GBM have not yet been reported. Objective To report on the feasibility of five-fraction SRS with the GammaKnife ICON in the management of newly diagnosed GBM. Methods In this single institutional study, we retrospectively reviewed all patients from our medical center from January 2017 through December 2021 who received fractionated SRS with Gamma Knife ICON for newly diagnosed GBM. Patient demographics, upfront surgical margins, molecular subtyping, radiation treatment volumes, systemic therapies, and follow-up imaging findings were extracted to report on oncologic outcomes. Results We identified six patients treated within the above time frame. Median age at diagnosis was 73.5 years, 66% were male, and had a median Karnofsky Performance Status (KPS) of 70. All tumors were IDH wild-type, and all but one were MGMT methylated and received concurrent temozolomide (TMZ). Within this group, progression free survival was comparable to that of historical data without significant radiation-induced toxicities. Conclusion Gamma Knife ICON may be discussed as a potential treatment option for select GBM patients and warrants further investigation in the prospective setting. |
| first_indexed | 2024-04-13T17:23:11Z |
| format | Article |
| id | doaj.art-6bcb3521ba434bcf85768f28b816569d |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T17:23:11Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-6bcb3521ba434bcf85768f28b816569d2022-12-22T02:37:54ZengBMCBMC Cancer1471-24072022-10-012211610.1186/s12885-022-10162-wFeasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed GlioblastomaMatthew Gallitto0Michelle Savacool1Albert Lee2Tony J. C. Wang3Michael B. Sisti4Department of Radiation Oncology, Columbia University Irving Medical CenterDepartment of Radiation Oncology, Columbia University Irving Medical CenterDepartment of Radiation Oncology, Columbia University Irving Medical CenterDepartment of Radiation Oncology, Columbia University Irving Medical CenterDepartment of Neurological Surgery, Columbia University Irving Medical CenterAbstract Background Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, with overall survival remaining poor despite ongoing efforts to explore new treatment paradigms. Given these outcomes, efforts have been made to shorten treatment time. Recent data report on the safety of CyberKnife (CK) fractionated stereotactic radiosurgery (SRS) in the management of GBM using a five-fraction regimen. The latest Gamma Knife (GK) model also supports frameless SRS, and outcomes using GK SRS in the management of primary GBM have not yet been reported. Objective To report on the feasibility of five-fraction SRS with the GammaKnife ICON in the management of newly diagnosed GBM. Methods In this single institutional study, we retrospectively reviewed all patients from our medical center from January 2017 through December 2021 who received fractionated SRS with Gamma Knife ICON for newly diagnosed GBM. Patient demographics, upfront surgical margins, molecular subtyping, radiation treatment volumes, systemic therapies, and follow-up imaging findings were extracted to report on oncologic outcomes. Results We identified six patients treated within the above time frame. Median age at diagnosis was 73.5 years, 66% were male, and had a median Karnofsky Performance Status (KPS) of 70. All tumors were IDH wild-type, and all but one were MGMT methylated and received concurrent temozolomide (TMZ). Within this group, progression free survival was comparable to that of historical data without significant radiation-induced toxicities. Conclusion Gamma Knife ICON may be discussed as a potential treatment option for select GBM patients and warrants further investigation in the prospective setting.https://doi.org/10.1186/s12885-022-10162-wFrameless stereotactic radiosurgeryGamma KnifeGamma Knife ICONGlioblastomaHypofractionationRadiosurgery |
| spellingShingle | Matthew Gallitto Michelle Savacool Albert Lee Tony J. C. Wang Michael B. Sisti Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma BMC Cancer Frameless stereotactic radiosurgery Gamma Knife Gamma Knife ICON Glioblastoma Hypofractionation Radiosurgery |
| title | Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma |
| title_full | Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma |
| title_fullStr | Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma |
| title_full_unstemmed | Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma |
| title_short | Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma |
| title_sort | feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed glioblastoma |
| topic | Frameless stereotactic radiosurgery Gamma Knife Gamma Knife ICON Glioblastoma Hypofractionation Radiosurgery |
| url | https://doi.org/10.1186/s12885-022-10162-w |
| work_keys_str_mv | AT matthewgallitto feasibilityoffractionatedgammakniferadiosurgeryinthemanagementofnewlydiagnosedglioblastoma AT michellesavacool feasibilityoffractionatedgammakniferadiosurgeryinthemanagementofnewlydiagnosedglioblastoma AT albertlee feasibilityoffractionatedgammakniferadiosurgeryinthemanagementofnewlydiagnosedglioblastoma AT tonyjcwang feasibilityoffractionatedgammakniferadiosurgeryinthemanagementofnewlydiagnosedglioblastoma AT michaelbsisti feasibilityoffractionatedgammakniferadiosurgeryinthemanagementofnewlydiagnosedglioblastoma |