STEREOTAXIC RADIOSURGERY FOR RECURRENT GLIOMAS

Background. The treatment of recurrent gliomas is palliative; however, the local pattern of tumor recurrence permits retreatment with single fraction, high dose stereotactic radiotherapy or radiosurgery (RS). M ethods. Twenty patients (median Karnofsky performance status, 80), age d 8-62 years with recurrent gliomas, were treated with RS after failin g adjuvant therapy. Tumor histologies included glioblastoma multiforme (5), anaplastic astrocytoma (10), fibrillary astrocytoma (4), and pri mitive neuroectodermal tumor (1). Tumor volumes ranged from 3-53.5 cc, with a median of 17 cc. Results. Seven early and one late radiation c omplication were seen. All seven early radiation complications were du e to raised intracranial pressure and resolved in all but one patient who died. Median follow-up in 19 evaluable patients was 8 months (rang e, 2-29 months). Fourteen patients died from progressive tumor (median survival, 7 months). Five patients, four with recurrent tumor, were a live (median follow-up, 19 months) with a median time-to-tumor progres sion of 9 months. Conclusions. Radiosurgery demonstrates modest effica cy with acceptable toxicity in selected patients with recurrent glioma s and warrants further investigation.