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MO_12_2766 - Radiosurgery outcome related to chemotherapy association in relapsed glioblastoma multiforme.

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Radiosurgery outcome related to chemotherapy association in relapsed glioblastoma multiforme.
L. Larrea1, E. Lopez1, P. Antonini1, V. Gonzalez1, M. A. Berenguer2, M. C. Baños1, J. Bea1, and M. A. Garcia1; 1Hospital NISA Virgen del Consuelo, Valencia, Spain, 2Radiation Oncology Department. Catalan Institute of Oncology, L'Hospitalet-Barcelona, Spain

Purpose/Objective(s): Treatment of glioblastoma multiforme (GBM) recurrence is currently an oncology challenge. Radiosurgery (SRS) may be an option. However, this technique still remains controversial. In this retrospective study we describe our experience.

Materials/Methods: Between January 2000 and March 2016, 40 patients with relapsed GBM, confirmed by magnetic resonance (MR), more than 6 months after the end of initial radiotherapy, were treated with SRS in our institution. It is an heterogeneous group, 27 patients had associated concomitant systemic chemotherapy to SRS; 16 patients were treated with bevazizumab and 11 patients received Temozolamide. Before relapsing, all of these 27 patients were treated with surgery, chemotherapy and radiotherapy according to STUPP protocol. The stereotactic frame was placed on the patient and the treatment was performed with LINAC and cones or micromultilamina collimator (MML). Mean age was 53.2 years for all patients and 55.2 years in associated chemotherapy subgroup. Number of lesions treated in each patient with SRS was 1 to 4 (mean 1.44 and 1.52 in chemo subgroup) and mean volume was 16,23 cc (range 0,63-58.48). Mean prescription dose was 14,3 Gy (range 10-18) in single fraction. Patients were discharged from the hospital the same day of treatment without corticosteroids.

Results: With a median follow-up of 16.82 months (range 6-42) in the 40 patients treated with SRS, progression-free survival after SRS treatment was 9.6 months and 9.9 months in the chemo subgroup. Overall survival was 27.5 months (9-48 months) (figure 1). In the 27 patients treated with chemotherapy, progression-free survival after SRS was 18.5 months; 20.9 months with bevazizumab and 12.2 months with temozolamide treated patients (p=0,004) (figure 2). Overall survival was 26.2 months; 31.2 with bevazizumab and 21,7 months with temozolamide (p=0,009) (figure 3). Multivariate analysis revealed that only age younger than 65 years was related with survival after SRS (p=0,024). After SRS most of patients remained without associated toxicity; asthenia and headache were described in 3 and 2 patients respectively. One patient showed asymptomatic adverse radiation effect (ARE) in MRI.

Conclusion: In our experience, the combination of SRS and bevazizumab improve progression-free and overall survival in patients with GBM relapse with low rates of toxicity.

Author Disclosure: L. Larrea: None. E. Lopez: None. P. Antonini: None. M. Berenguer: None. J. Bea: None.

Luis Larrea, MD, PhD

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