Results following stereotactic radiosurgery for patients with glioblastoma multiforme

Objective: During a 15-year interval we evaluated the clinical results following stereo tactic radiosurgery as part of multimodality management in 180 patients with glioblastoma multiforme (GBM). Methods: Adjuvant radiosurgery was performed either prior to disease progression or for recurrent tumor at the time of disease progression. The mean age was 56 years, the mean Karnofsky performance score at radiosurgery was 90, and the median RTOG grade was 4. Tumor location was lobar in 137, deep in 13, and both in 30 patients. Results: Median Survival for GBM patients after initial diagnosis in the entire series was 18 months (95% CI 16-20). The median survival after radiosurgery was 10 months. The 2-year survival rate was 34%, and the 5-year survival, 14%. Prolonged survival was related to use of chemotherapy (p < 0.001), presentation with seizures (p < 0.001), younger age (p < 0.0001), prior resection (p = 0.007), but not use of radiation therapy, tumor location, or gender. Eleven patients had an adverse radiation effect (5.8%). Thirteen patients underwent repeat radiosurgery and 46 had a repeat resection. Patients with tumor regression after radiosurgery lived a median of 33 months, whereas patients with a tumor enlargement lived a median of 17 months (p = 0.006). Conclusions: Radiosurgery may provide a survival benefit for patients with GBM as part of multimodality management. This benefit may be related to patient selection although an imaging defined tumor response correlated with improved Survival. Radiosurgery is safe and well tolerated. Copyright (C) 2004 S. Karger AG, Basel.