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Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma

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 Cybe...

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Autores principales: Gallitto, Matthew, Savacool, Michelle, Lee, Albert, Wang, Tony J. C., Sisti, Michael B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608921/
https://www.ncbi.nlm.nih.gov/pubmed/36289477
http://dx.doi.org/10.1186/s12885-022-10162-w
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author Gallitto, Matthew
Savacool, Michelle
Lee, Albert
Wang, Tony J. C.
Sisti, Michael B.
author_facet Gallitto, Matthew
Savacool, Michelle
Lee, Albert
Wang, Tony J. C.
Sisti, Michael B.
author_sort Gallitto, Matthew
collection PubMed
description 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.
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spelling pubmed-96089212022-10-28 Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma Gallitto, Matthew Savacool, Michelle Lee, Albert Wang, Tony J. C. Sisti, Michael B. BMC Cancer Research 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. BioMed Central 2022-10-26 /pmc/articles/PMC9608921/ /pubmed/36289477 http://dx.doi.org/10.1186/s12885-022-10162-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gallitto, Matthew
Savacool, Michelle
Lee, Albert
Wang, Tony J. C.
Sisti, Michael B.
Feasibility of fractionated gamma knife radiosurgery in the management of newly diagnosed Glioblastoma
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 Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608921/
https://www.ncbi.nlm.nih.gov/pubmed/36289477
http://dx.doi.org/10.1186/s12885-022-10162-w
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