[Not Available].

Abstract

Purpose of the study: To evaluate the efficacy of fractionated stereotactic reirradiation with CyberKnife (CK) performed in 6 patients with high grade gliomas treated in Luxembourg with local recurrence (LR).

Patients and methods: Between 04.2014 and 06.2016, 6 patients with multiform grade IV gliomas LR were reirradiated with CK (protocol CNER re-RT CFB 1), as reirradiation. The mean time between primary radiotherapy and local recurrence (LR) is 14.1 months [4 - 38]. CK is performed with a dose of 36 Gy in 6 fractions (5 cases) and 30 Gy in 3 fractions (1 case) Results : LR after CK (progression free survival) is 3.4 months [2 - 7] (5 cases assessment). Mean survival after CK is 12 months [3 - 22] (3 cases assessment). Mean survival after initial diagnosis is 37 months [17 - 58] (3 cases assessment). No toxicity is noticed (4 cases assessment). Time to first progression after primary treatment is a strong predictor for survival. Fractionated stereotactic reirradiation with CK is well tolerated and effective (survival) in patients with LR high grade gliomas. In accordance with these results, the CFB Conseil Scientifique recommends a new paradigm for MRI follow-up high grade gliomas. After first line treatment, an MRI has to be performed every 3 months, to identify LR earlier, and to offer the patients a way of salvage with CK option, in order to increase his chances of better survival.