Application of radiotherapy and stereotactic radiosurgery in treatment of patients with brain gliosarcoma – preliminary results
Journal Title: Annales Academiae Medicae Silesiensis - Year 2014, Vol 68, Issue 5
Abstract
AIM The aim of the work is to evaluate the results of the treatment of gliosarcoma according to the applied therapeutic methods. MATERIAL AND METHODS 43 patients (15 women and 28 men) aged 21 to 80 years were treated for brain gliosarcoma in the years 2002– –2014 in Institute of Oncology in Gliwice. In 22 cases the tumor was located in one lobe, in 20 at least two lobes of the brain were occupied. The initial diameter of the tumor, assessed in 22 patients (CT/MRI), ranged from 2 to 8 cm (median 5). Surgery was the primary treatment in 42 cases. Radiotherapy was performed in 35 patients (81.4 %), in 16 radical (median TD = 60 Gy, 12 cases of radiochemotherapy with temozolomide), in 12 palliative (median TD = 20 Gy), in 7 palliative combined with a stereotactic boost (median TD of boost 9.5 Gy, range: 6–15 Gy). 28 patients had regular check-ups. In 20 recurrence of the tumor was found. In the treatment of the recurrence, radiotherapy was used in 9 patients (in 6 patients combined with surgery; in 7 stereotactic radiotherapy (TD = 8–16 Gy, fd = 6–10 Gy), in 2 surgical treatment. RESULTS The follow-up ranged from 1.3 to 74 months. 32 patients died due to disease progression. The median survival for patients treated with surgery alone, surgery and palliative radiotherapy, surgery and palliative radiotherapy combined with stereotactic boost, surgery and radical radiotherapy was respectively 2.1, 5.4, 9.7 and 14.1 months (p = 0.008). In the case of recurrence, the median survival in the case of symptomatic treatment, surgery, and stereotactic radiosurgery was respectively 5.4, 6.5 and 18 months. CONCLUSIONS Radiotherapy is an essential element of brain gliosarcoma treatment resulting in significant prolongation of life. Stereotactic radiosurgery as a complementary element of palliative treatment and treatment of progression/ recurrence additionally increases survival in this group of patients.
Authors and Affiliations
Aleksandra Napieralska, Sławomir Blamek
Keywords
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