Minim Invasive Neurosurg 2006; 49(2): 110-115
DOI: 10.1055/s-2006-932183
Original Article
© Georg Thieme Verlag Stuttgart · New York

CyberKnife Stereotactic Radiotherapy for Patients with Malignant Glioma

K.  Yoshikawa1 , K.  Saito2 , K.  Kajiwara1 , S.  Nomura1 , H.  Ishihara1 , M.  Suzuki1
  • 1Department of Neurosurgery, Yamaguchi University School of Medicine, Yamaguchi, Japan
  • 2Department of Neurosurgery, Konan St. Hill Hospital, Yamaguchi, Japan
Further Information

Publication History

Publication Date:
18 May 2006 (online)

Abstract

Objective: The CyberKnife is a new frameless image-guided radiosurgical modality. The authors report on their experience using the CyberKnife in 25 patients with malignant gliomas. Methods: Twenty-five patients with histologically proven malignant gliomas (18 glioblastoma: GB, 7 anaplastic astrocytoma: AA) were treated with the CyberKnife at Konan St. Hill Hospital between June 1998 and November 2002. CyberKnife therapy was performed on 44 lesions (31 GB lesions, 13 AA lesions) in the 25 patients. The median target volume was 19.1 mL (range: 0.3 - 90.2). The median prescribed dose was 20.3 Gy (range: 13.9 - 26.4). Patient-, tumor-, and treatment-related variables were analyzed by univariate analysis, and survival curves were generated by the Kaplan-Meier product limit. Results: In the 18GB patients, the median survival after diagnosis was 20.7 months (82.6 weeks) with a mean follow-up of 85.7 weeks. Of the 7 AA patients, 6 were alive at the time of analysis with follow-up periods ranging from 11.4 to 52.8 months. Patients younger than 70 years had a median survival after diagnosis of 37.1 months, compared to 12.4 months for older patients (p = 0.003). Similarly, patients with well-controlled lesions had a median survival after diagnosis of 39.8 months compared to 16.0 months for those with uncontrolled lesions (p = 0.031). Late delayed radiation necrosis was seen in 1 GB patient. No other patient suffered acute or delayed neurological morbidity after CyberKnife therapy. Conclusion: This is the first report of CyberKnife stereotactic radiotherapy applied to the treatment of malignant gliomas. The frameless and painless CyberKnife stereotactic radiotherapy has the potential to be as useful for treatment of malignant glioma as other radiosurgical modalities.

References

Koji Kajiwara,, M. D. 

Department of Neurosurgery · Yamaguchi University School of Medicine

1-1-1 Minamikogushi

Ube, Yamaguchi 755-8505

Japan

Phone: +81/836/22/2295 ·

Fax: +81/836/22/2294

Email: koji@yamaguchi-u.ac.jp