The Clinical Study Of Cyberknife In Recurrent Gliomas

Background:Cyberknife is an advanced stereotactic radiosurgery equipment,which can be used to treat tumors of the whole body and intracranial and spinal diseases.The studys show Cyberknife for gliomas is effective and safe.So far,few reports have been published on clinical experience in the recurrent glioma treated by Cyberknife.Object:To study the safety and the efficacy in the near future in the patients with recurrent gliomas treated by Cyberknife.Method:Patients with histologically proven gliomas who have treated with chemotherapy and radiotreapy after surgery and found recurrent with imageology at huashan hospital between Jan 2008 and June 2008.All patients have treated radiotreapy more than 50Gy(include 50Gy),chemotherapy are not limited,and the Karnofsky score more than 60(include 60).patients are into Cyberknife treatment team and contrast team with random envelope.The treatment team use cyberknife treat rencurrent lesion and the contrast team have no radiotherapy.patients are follow-up for study the safety and the efficacy,and survival curves were generated by the Kaplan-Meier product limit.40 patients are average into two teams.Results:20 patients are treated with cyberknife,The median target volume was 30107.4 ml(range:5874-69000ml),The median prescribed dose was 21.8 Gy(range: 14～26Gy),The median isodose curve was 74.1%(range:68～80%).No patient suffered acute neurological morbidity after CyberKnife therapy.The white blood cell and Liver function were normal after CyberKnife therapy.There are 3 patients need Mannitol and Dexamethasone,whose CT/MRI after 3-6 months found brain edema increase.The two of the twenty tumors(10%) showed a volume decrease,no change is eight(40%) and increase ten(50%),effective power is 10%and control rate is 50%. The median follow-up is 36.8 weeks(13-59weeks,median 36 weeks).The median survival time of Cyberknife treatment team is 40 weeks and the contrast team is 29 weeks.The survival rate between two teams were significant deviation(P＜0.05).Conclusion:(1)Cybeknife treat recurrent gliomas has highly safety;(2)The good control rate of the recurrent lesion can be found in the near future;(3) CyberKnife stereotactic radiotherapy has the potential to be as useful for treatment of recurrent gliomas as other radiosurgical modalities.