Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority ...Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed.展开更多
目的:通过对体部伽玛刀(γ-ray Stereotactic Body Radiation Therapy)治疗原理的论述,说明在体部伽玛刀精确放疗中质量保证(QA)与质量控制(QC)的重要性。方法:分析影响靶区剂量准确性的各个因素,阐明体部伽玛刀治疗中需要进行QA的重点...目的:通过对体部伽玛刀(γ-ray Stereotactic Body Radiation Therapy)治疗原理的论述,说明在体部伽玛刀精确放疗中质量保证(QA)与质量控制(QC)的重要性。方法:分析影响靶区剂量准确性的各个因素,阐明体部伽玛刀治疗中需要进行QA的重点方面。结果:通过体部伽玛刀的QA和QC,可以保证其治疗的精确性,提高治疗效果。结论:QA在体部伽玛刀治疗实施中应置于首要地位,是保证治疗效果的关键。需要通过放疗医生、物理师、放疗技术员多个环节责任分工共同实现。展开更多
文摘Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed.
文摘目的:通过对体部伽玛刀(γ-ray Stereotactic Body Radiation Therapy)治疗原理的论述,说明在体部伽玛刀精确放疗中质量保证(QA)与质量控制(QC)的重要性。方法:分析影响靶区剂量准确性的各个因素,阐明体部伽玛刀治疗中需要进行QA的重点方面。结果:通过体部伽玛刀的QA和QC,可以保证其治疗的精确性,提高治疗效果。结论:QA在体部伽玛刀治疗实施中应置于首要地位,是保证治疗效果的关键。需要通过放疗医生、物理师、放疗技术员多个环节责任分工共同实现。
