gms | German Medical Science

65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. - 14. Mai 2014, Dresden

Artikel

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Recurrent glioblastoma multiforme: the role of combined salvage therapies and introduction of a new treatment algorithm

Meeting Abstract

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  • Eleftherios Archavlis - Neurochirurgische Klinik und Ambulanz, Sana Klinikum Offenbach, Akademisches Lehrkrankenhaus der Universität Frankfurt, Offenbach, Deutschland
  • Nikolaos Tselis - Strahlenklinik, Sana Klinikum Offenbach, Akademisches Lehrkrankenhaus der Universität Frankfurt, Offenbach, Deutschland
  • Gerhard Birn - Neurochirurgische Klinik, Klinikum Darmstadt, Akademisches Lehrkrankenhaus der Universität Frankfurt, Darmstadt, Deutschland
  • Peter Ulrich - Neurochirurgische Klinik und Ambulanz, Sana Klinikum Offenbach, Akademisches Lehrkrankenhaus der Universität Frankfurt, Offenbach, Deutschland; Neurochirurgische Klinik, Klinikum Darmstadt, Akademisches Lehrkrankenhaus der Universität Frankfurt, Darmstadt, Deutschland
  • Nikolaos Zamboglou - Strahlenklinik, Sana Klinikum Offenbach, Akademisches Lehrkrankenhaus der Universität Frankfurt, Offenbach, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.17.06

doi: 10.3205/14dgnc374, urn:nbn:de:0183-14dgnc3744

Veröffentlicht: 13. Mai 2014

© 2014 Archavlis et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

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Objective: Glioblastoma multiforme patients presenting a recurrence following multimodality therapy have limited palliative treatment options when these major modalities of therapy have been exhausted. The authors introduce a clinical and radiological indication-solving algorithm and provide outcome rates of a glioblastoma recurrence cohort after multimodal salvage treatment.

Method: In the period from 2008-2010, 33 consecutive adult patients with recurrent glioblastoma underwent a combined scheme of salvage treatments including reoperation, high dose rate (HDR) brachytherapy and chemotherapy. All patients were previously treated with surgery of the primary pathology, concomitant and adjuvant radiochemotherapy with temozolomide. During HDR-brachytherapy, a median dose of 40 Gy was prescribed. Radiation Therapy Oncology Group (RTOG) criteria were used to assess toxicities associated with these treatments.

Results: Median follow-up was 32 months (range 28-36 months). Median survival was 9 months for the entire cohort after salvage treatment and can be translated into a 3-month improvement in survival compared to the control group of patients with glioblastoma recurrence treated with temozolomide alone (P=0.043). Reoperation and HDR-brachytherapy combined with chemotherapy renders acceptable complication rates and seem to be a reasonable salvage option for patients with recurrent glioblastoma.

Conclusions: Our experience suggests that a combined salvage treatment plan appears to be either feasible or effective and can be considered in selected patients affected by recurrent high-grade gliomas. The authors’ clinical and radiological indication-solving algorithm may assist in providing the best possible salvage treatment for this difficult population.