Analizar en un estudio fase II el control local, tiempo a progresión y supervivencia (SPV) de pacientes con glioma cerebral primario de alto grado tratados con radiocirugía estereotáxica (RC), como tratamiento de intensificación local.
Material y métodosDieciocho pacientes, 8 astrocitomas anaplásicos y 10 glioblastomas multiformes de diámetro máximo menor o igual a 5cm, han sido tratados con RC, administrándose una dosis margen que incluye el volumen tumoral de 10–20 Gy (mediana: 15 Gy), alcanzando una dosis máxima intratumoral de 12.5–40 Gy (mediana 17 Gy). Catorce pacientes (78%) recibieron radioterapia externa fraccionada (mediana de dosis: 60 Gy).
ResultadosLa mediana de SPV ha sido 11.5 meses y la SPV actuarial a 1 y 2 años de 42.5% y 10.6% respectivamente. Diez de 18 pacientes (55%) presentaron progresión tumoral con una mediana de tiempo a progresión de 10 meses (límites: 1–14 meses). Sólo 1 paciente (5.5%) desarrolló toxicidad severa.
ConclusionesLa RC es una atractiva modalidad de tratamiento de intensificación local en glioma maligno cerebral de tamaño menor o igual a 5cm, tolerable y factible.
To analyze in a phase II clinical trial the local control, time to progression and survival of patients with primary malignant glioma treated with stereotactic radiosurgery (SRS) as a treatment boost.
Methods and material A total of 18 patients, with anaplastic astrocytomas (8 cases) and glioblastoma multiformes (10 cases) (maximum diameter=5cm) have been treated with SRS, receiving a single marginal tumor dose of 10–20 Gy (median: 15 Gy), at 90% isodose line, and achieving a maximun tumor dose of 12.5–40 Gy (median: 17 Gy). Fourteen patients (78%) were treated with external beam radiotherapy (median dose: 60 Gy).
ResultsThe median survival time was 11.5 months, and the 1 -and 2-year actuarial survival were 42.5% and 10.6% respectively. Ten out of 18 patients (55%) had tumor progression and the median time to tumor progression was 10 months (range: 1–14 months). One patient (5.5%) developed severe toxicity.
ConclusionSRS is an attractive, feasible and tolerable treatment modality for local intensification in malignant glioma, lesser o equal than 5cm in size.
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