Outcomes and prognostic stratification of patients with recurrent glioblastoma treated with salvage stereotactic radiosurgery.


OBJECTIVE:Glioblastoma (GBM) is the most malignant form of astrocytoma. The average survival is 6-10 months in patients with recurrent GBM (rGBM). In this study, the authors evaluated the role of stereotactic radiosurgery (SRS) in patients with rGBMs. METHODS:The authors performed a retrospective review of their brain tumor database (1997-2016). Overall survival (OS) and progression-free survival (PFS) after salvage SRS were the primary endpoints evaluated. Response to SRS was assessed using volumetric MR images. RESULTS:Fifty-three patients with rGBM underwent salvage SRS targeting 75 lesions. The median tumor diameter and volume were 2.55 cm and 3.80 cm3, respectively. The median prescription dose was 18 Gy (range 12-24 Gy) and the homogeneity index was 1.90 (range 1.11-2.02). The median OS after salvage SRS was estimated to be 11.0 months (95% CI 7.1-12.2) and the median PFS after salvage SRS was 4.4 months (95% CI 3.7-5.0). A Karnofsky Performance Scale score ≥ 80 was independently associated with longer OS, while small tumor volume (< 15 cm3) and less homogeneous treatment plans (homogeneity index > 1.75) were both independently associated with longer OS (p = 0.007 and 0.03) and PFS (p = 0.01 and 0.002, respectively). Based on these factors, 2 prognostic groups were identified for PFS (5.4 vs 3.2 months), while 3 were identified for OS (median OS of 15.2 vs 10.5 vs 5.2 months). CONCLUSIONS:SRS is associated with longer OS and/or PFS in patients with good performance status, small-volume tumor recurrences, and heterogeneous treatment plans. The authors propose a prognostic model to identify a cohort of rGBM patients who may benefit from SRS.


J Neurosurg


Journal of neurosurgery


Sharma M,Schroeder JL,Elson P,Meola A,Barnett GH,Vogelbaum MA,Suh JH,Chao ST,Mohammadi AM,Stevens GHJ,Murphy ES,Angelov L




Has Abstract


2018-10-19 00:00:00














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    abstract:OBJECT:Factors determining choice of an academic career in neurological surgery are unclear. This study seeks to evaluate the graduates of medical schools and US residency programs to determine those programs that produce a high number of graduates remaining within academic programs and the contribution of these gradua...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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  • Vestibular schwannoma surgery in the elderly: a matched cohort study.

    abstract:OBJECT:The authors' objective was 2-fold: 1) to compare outcomes of microsurgical resection for vestibular schwannoma (VS) between patients aged 70 years or older and patients younger than 70 years and 2) to test the hypothesis that symptomatic tumors in elderly patients represent a more aggressive variant of VS than t...

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    authors: Van Abel KM,Carlson ML,Driscoll CL,Neff BA,Link MJ

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  • Biphasic ventricular dilatation following posterior fossa subdural hematoma in the full-term neonate.

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    authors: Tanaka Y,Sakamoto K,Kobayashi S,Kobayashi N,Muraoka S

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  • Stereotactic radiosurgery for arteriovenous malformations after Onyx embolization: a case-control study.

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  • Postirradiation sarcomatous transformation of a pituitary adenoma: a combined pituitary tumor. Case report.

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    authors: Pieterse S,Dinning TA,Blumbergs PC

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  • Nerve reconstruction in lumbosacral plexopathy. Case report and review of the literature.

    abstract::Neurological injury to the lumbosacral plexus associated with pelvic and sacral fractures has traditionally been treated conservatively, despite significant and often debilitating functional deficits of the lower extremities. The authors report a case of reconstruction of the lumbosacral plexus, including nerve grafti...

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    authors: Tung TH,Martin DZ,Novak CB,Lauryssen C,Mackinnon SE

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  • Neuroprotective and neurorestorative effects of thymosin β4 treatment initiated 6 hours after traumatic brain injury in rats.

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  • Infarction of the spinal cord as a complication of pneumococcal meningitis. Case report.

    abstract::Spinal cord infarction in association with pneumococcal meningitis has not been previously recognized. The case is reported of a 5 1/2-year-old boy who had Streptococcus pneumoniae meningitis complicated by the sudden onset of flaccid paraplegia and loss of all sensory modalities below the level of T-2. At operation, ...

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    authors: Haupt HM,Kurlinski JP,Barnett NK,Epstein M

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  • Chordoid meningioma with polyclonal gammopathy. Case report.

    abstract::The authors present a case of chordoid meningioma in a 55-year-old woman who manifested headache and personality change. Magnetic resonance imaging of the brain and cerebral angiography demonstrated a mass in the right frontal lobe that resembled a typical convexity meningioma. However, the pathological diagnosis was ...

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    authors: Lee DK,Kim DG,Choe G,Chi JG,Jung HW

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  • Effect of regional spinal cord blood flow and central control in recovery from spinal cord injury.

    abstract::Forty-two cats were subjected to decerebration, thoracic and lumbar laminectomies, and isolation of the sciatic nerves. Spinal evoked potentials in response to bilateral sciatic nerve stimulation were recorded at L-3, and the spinal cord blood flow (SCBF) was measured by the hydrogen clearance technique. Thoracic cord...

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    pub_type: 杂志文章


    authors: Chehrazi BB,Scremin O,Decima EE

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    abstract:OBJECTIVE:The optimal margin size in postoperative stereotactic radiosurgery (SRS) for brain metastases is unknown. Herein, the authors investigated the effect of SRS planning target volume (PTV) margin on local recurrence and symptomatic radiation necrosis postoperatively. METHODS:Records of patients who received pos...

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    pub_type: 杂志文章


    authors: Jhaveri J,Chowdhary M,Zhang X,Press RH,Switchenko JM,Ferris MJ,Morgan TM,Roper J,Dhabaan A,Elder E,Eaton BR,Olson JJ,Curran WJ,Shu HG,Crocker IR,Patel KR

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    abstract::The pathology of hematomyelia was examined in 35 rats following the stereotactic injection of 2 microliters blood into the dorsal columns of the thoracic spinal cord. This experimental model produced a small ball-hemorrhage without associated neurological deficits or significant tissue injury. Histological sections of...

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    pub_type: 杂志文章


    authors: Milhorat TH,Adler DE,Heger IM,Miller JI,Hollenberg-Sher JR

    更新日期:1991-12-01 00:00:00

  • Analysis of intra- and intercellular calcium signaling in a mouse malignant glioma cell line.

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    pub_type: 杂志文章


    authors: Yamasaki T,Enomoto K,Moritake K,Maeno T

    更新日期:1994-09-01 00:00:00

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    authors: Stein SC,Burnett MG,Sonnad SS

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    pub_type: 杂志文章


    authors: Kim LJ,Klopfenstein JD,Cheng M,Nagul M,Coons S,Fredenberg C,Brachman DG,White WL

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  • A graft-versus-tumor effect in a patient with ependymoma who received an allogenic bone marrow transplant for therapy-related leukemia. Case report.

    abstract::Graft-versus-leukemia effect is an immune-mediated antitumor phenomenon associated with allogenic bone marrow transplants (BMTs) for hematological malignancies, and recent findings have indicated that a similar effect could occur in some solid tumors such as breast cancers. The authors report on a 42-year-old man with...

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    authors: Tanaka M,Shibui S,Kobayashi Y,Nomura K,Nakanishi Y

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Weiss IP,Schiff SJ

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  • Surgical outcomes for medically intractable epilepsy in low- and middle-income countries: a systematic review and meta-analysis.

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    pub_type: 杂志文章


    authors: Magnaes B

    更新日期:1982-07-01 00:00:00

  • Maduromycosis of the brain. Case report.

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    pub_type: 杂志文章


    authors: Natarajan M,Balakrishnan D,Muthu AK,Arumugham K

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  • Ossification of the pterygoalar and pterygospinous ligaments: a computed tomography analysis of infratemporal fossa anatomical variants relevant to percutaneous trigeminal rhizotomy.

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    pub_type: 杂志文章


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    pub_type: 杂志文章


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    更新日期:1997-08-01 00:00:00

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    pub_type: 杂志文章


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    pub_type: 杂志文章


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    更新日期:2006-07-01 00:00:00

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Fujita Y,Doi K,Harada D,Kamikawa S

    更新日期:2010-04-01 00:00:00

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kramer AH,Hehir M,Nathan B,Gress D,Dumont AS,Kassell NF,Bleck TP

    更新日期:2008-08-01 00:00:00

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    pub_type: 杂志文章,多中心研究


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    更新日期:2012-08-01 00:00:00