The effectiveness of gamma knife radiosurgery for the management of residual high-grade gliomas: A single institutional study

2022 ◽  
Vol 95 ◽  
pp. 159-163
Author(s):  
Fatih Yakar ◽  
Emrah Egemen ◽  
Ümit A Dere ◽  
Halil Sağınç ◽  
Ulaş Gökdeniz ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
High Grade ◽  
High Grade Gliomas

768 Gamma Knife Radiosurgery Boost in High-grade Gliomas

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 527-527
Author(s):  
Rufus J. Mark ◽  
Ronald Young ◽  
Deane Jacques ◽  
Brian Copcutt ◽  
Sandra Vermeulen ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
High Grade ◽  
High Grade Gliomas

2086 Gamma knife radiosurgery boost in high grade gliomas

1999 ◽  
Vol 45 (3) ◽  
pp. 322
Author(s):  
R.J. Mark ◽  
R.F. Young ◽  
D.B. Jacques ◽  
B.G. Copcutt ◽  
S.S. Vermeulen ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
High Grade ◽  
High Grade Gliomas

scholarly journals RT-28 * INSTITUTIONAL REVIEW OF GAMMA KNIFE RADIOSURGERY IN PRIMARY AND RECURRENT HIGH-GRADE GLIOMAS

2014 ◽  
Vol 16 (suppl 5) ◽  
pp. v193-v193
Author(s):  
R. Planchard ◽  
K. Merrell ◽  
S. Thalacker ◽  
I. Parney ◽  
N. Laack
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
High Grade ◽  
Institutional Review ◽  
High Grade Gliomas

scholarly journals AT-45 * GAMMA KNIFE RADIOSURGERY FOR RECURRENT HIGH GRADE GLIOMAS

2014 ◽  
Vol 16 (suppl 5) ◽  
pp. v18-v18
Author(s):  
S. Peker ◽  
I. A. Kabalay ◽  
E. Tezcanli ◽  
M. Yilmaz ◽  
M. Sengoz
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
High Grade ◽  
High Grade Gliomas

768 Gamma Knife Radiosurgery Boost in High-grade Gliomas

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 527
Author(s):  
Rufus J. Mark ◽  
Ronald Young ◽  
Deane Jacques ◽  
Brian Copcutt ◽  
Sandra Vermeulen ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
High Grade ◽  
High Grade Gliomas

scholarly journals Efficacy of Gamma Knife Radiosurgery for Recurrent High-Grade Gliomas with Limited Tumor Volume

2018 ◽  
Vol 61 (4) ◽  
pp. 516-524 ◽  
Author(s):  
Young-Jun Cheon ◽  
Tae-Young Jung ◽  
Shin Jung ◽  
In-Young Kim ◽  
Kyung-Sub Moon ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Tumor Volume ◽  
Gamma Knife Radiosurgery ◽  
High Grade ◽  
High Grade Gliomas

scholarly journals P14.98 Improving the targeting of Gamma-Knife radiosurgery for recurrent high-grade gliomas (WHO grades III and IV) with 11C-Methionine PET/CT

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii91-iii91
Author(s):  
E Chaskis ◽  
G Van Simaeys ◽  
C Martens ◽  
O De Witte ◽  
S Goldman ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Multidisciplinary Approach ◽  
Gamma Knife Radiosurgery ◽  
High Grade ◽  
Who Grade ◽  
Metabolic Monitoring ◽  
Pet Ct ◽  
High Grade Gliomas ◽  
A Prospective Study ◽  
Median Interval

Abstract BACKGROUND The survival of the patients with high-grade gliomas may be improved through a multidisciplinary approach including stereotactic re-irradiation such as Gamma-Knife at recurrence in a selected population. We report our experience in targeting the hypermetabolic areas of high-grade gliomas using 11C-Methionine PET/CT in selected patients. MATERIAL AND METHODS We retrospectively evaluated the local response in patients treated by Gamma-Knife for recurrent high-grade gliomas in our Institution between 2000 and 2018, targeting the hypermetabolic area with Methionine PET/CT. RESULTS We included 25 patients bearing high-grade gliomas (14 female, 11 male) with a median age of 45 years (5–64). There were 11 WHO grade III gliomas (6 astrocytomas, 5 oligodendrogliomas) and 14 glioblastomas. A total number of 33 Gamma-Knife procedures were performed. In all patients, the targeting was based on the hypermetabolic area as defined by Methionine PET/CT. Four patients were treated concomitantly on 2 or more targets. One patient was treated twice on different targets. We observed a positive response in 29 Gamma-Knife procedures, after a median interval of 2 months (1–33) and no response after 4 procedures (4 glioblastomas). In most cases, progression after Gamma-Knife was observed 4 months after irradiation. CONCLUSION Targeting the hypermetabolic areas with Methionine PET/CT was associated with favorable response in most patients treated by Gamma-Knife radiosurgery for local high-grade gliomas recurrence. Our results must be confirmed by a prospective study with regular and homogeneous morphological and metabolic monitoring.

Increased Survival Using Delayed Gamma Knife Radiosurgery for Recurrent High-Grade Glioma: A Feasibility Study

2014 ◽  
Vol 82 (5) ◽  
pp. e623-e632 ◽  
Author(s):  
Ernest Dodoo ◽  
Beate Huffmann ◽  
Inti Peredo ◽  
Hanne Grinaker ◽  
Georges Sinclair ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Feasibility Study ◽  
Gamma Knife Radiosurgery ◽  
High Grade Glioma ◽  
High Grade

scholarly journals Contribution of spectroscopic magnetic resonance imaging to target volume delineation in Gamma Knife Radiosurgery: Myth or reality?

2021 ◽  
pp. 2-2
Keyword(s):  
Magnetic Resonance ◽  
Brain Metastasis ◽  
Gamma Knife ◽  
Tumor Volume ◽  
Gamma Knife Radiosurgery ◽  
Target Volume ◽  
High Grade ◽  
Target Delineation ◽  
Perilesional Edema ◽  
Volume Delineation

Brain malignancies are still associated with poor prognosis despite multimodal radiosurgical therapeutic approach using Gamma Knife (GK), CyberKnife (CK), and linear accelerator-based technologies [1]. These advances have significantly improved the treatment outcome. However, the surgical and radiosurgical concept is still “image-guided”, and the success is closely related to precise tumor volume definition. The gross tumor volume (GTV) is defined as the visible contrast- enhancing lesion on magnetic resonance (MR) images with high three-dimensional spatial accuracy. Target delineation requires always both T2-weighted and volumetric T1-weighted sequences. T2-weighted fluid attenuated inversion recovery (FLAIR) sequences analyze the lesions surrounding brain tissues [2,3]. Objective assessment of apparently healthy tissue surrounding brain tumors seems to be a considerable factor interfering not only with the radiosurgical procedure, but also with the recurrence rate and overall survival. Several studies identified infiltrative spectroscopic pattern of the perilesional edema in more than 96% of high-grade gliomas cases and in 11,5% of patients with brain metastasis [4]. Moreover, some autopsy series of brain metastases confirmed infiltrative growth in radiologically healthy surrounding tissues in more than 60% of cases. This unseen malignant component is responsible of 80 % of “early recurrence” which should be considered as natural evolution of the main tumor [5]. In the management of high grade gliomas, the radiosurgeons are faced either to carcinologic incomplete procedures or to overestimated target irradiation with unbalanced benefit/risk action mostly related to radiation-induced brain necrosis [6]. The delineation of clinical target volume (CTV) which is defined as the volume of tissue that contains the GTV and any microscopic tumor or paths of spread, became a standard for any radio-surgical planning. Since a decade, the magnetic resonance spectroscopy (MRS) was standardized in the target volume assessment. The aim is to establish a metabolic lesional cartography. It had been reported that choline/ N- acetylaspartate (NAA) multivoxel MR spectroscopy index higher that 2,5 is in favor of malignancy in glioma with sensitivity of 90 % and specificity of 85 % [7]. However, NAA/Creatine (Cr) and Choline/Cr ratios are more relevant in the analysis of perilesional edema in brain metastasis cases. The introduction of MRS metabolic cartography concept, the use of relevant metabolite and adapted metabolites ratio estimation contributed to precision in radiosurgery. However, MRS is not used for target delineation for Gamma Knife radiosurgical treatment because of its incompatibility with the Leksell Gamma Knife planning software. Recently, we described the development of the first software allowing the integration of metabolic cartography based on multivoxel spectroscopic MRI in the radiosurgical planning for Leksell Gamma Knife Radiosurgery. The few existing meta-analysis could not lead to gold standard volume delineation techniques despite objective advance in imaging assessment [8,9]. Prospective studies using multimodal imaging data will help to overcome this insufficiency for target delineation in radiosurgery

Gamma Knife Radiosurgery for High-Grade Gliomas: Single-Center Experience of Six Years in China

2021 ◽  
Vol 99 (3) ◽  
pp. 181-186
Author(s):  
Ming Zhao ◽  
Xiangping Fu ◽  
Zhiwen Zhang ◽  
Liang Ma ◽  
Xiaopeng Wang ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Cox Regression ◽  
Survival Rates ◽  
Gamma Knife Radiosurgery ◽  
Progression Free Survival ◽  
High Grade Glioma ◽  
Karnofsky Performance Score ◽  
High Grade ◽  
Alternative Treatment Option ◽  
The Mean

<b><i>Objective:</i></b> The aim of this study was to evaluate the efficacy of Gamma Knife radiosurgery (GKRS) as a salvage therapy for high-grade glioma in our center. <b><i>Methods:</i></b> A total of 167 patients with malignant glioma were treated with GKRS in our Gamma Knife Center between January 2013 and December 2017; 140 patients (85 males and 55 females) were followed up and enrolled in our study. A single lesion was found in 110 cases, and multiple lesions were found in 30 cases; 108 cases received a single therapy, and in 32 cases, at least 2 GKRSs were performed. The median tumor volume was 13.5 cm<sup>3</sup>. The mean radiation dosage was 14.35 Gy (range, 6–18 Gy). MRI was performed regularly. The RANO criteria and Cox analysis were used to evaluate the therapeutic efficiency. <b><i>Results:</i></b> Follow-up MRI showed the local control rate was 61.4% at 3 months after GKRS, 25.0% at 6 months, and 7.1% at 12 months. The mean and median progression-free survival (PFS) periods were 8.6 (95% CI, 6.3–11.0) and 4 (95% CI, 3.5–4.5) (range, 1–60) months, respectively. The overall survival (OS) after GKRS was 3–62 months, with a mean of 16.7 (95% CI, 14.6–18.9) months, and the median survival was 13 (95% CI, 12.1–13.9) months. The 1-, 2-, and 5-year survival rates were 51.4, 10.0, and 2.9%, respectively. No severe complications occurred. Cox regression showed that glioma pathology was closely related to prognosis (<i>p</i> &#x3c; 0.05). The Karnofsky Performance Score had little influence on PFS (<i>p</i> &#x3e; 0.05) but influenced OS significantly (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> GKRS can be used to effectively treat malignant brain glioma and can therefore be used as an alternative treatment option.

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